PT  - JOURNAL ARTICLE
AU  - Pai-Chien Chou
AU  - Chun-Hwa Wang
AU  - Han-Pin Kuo
TI  - Clinical effectiveness of anti-IgE therapy in allergic severe asthma
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P908
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P908.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P908.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Severe asthma patients remain symptomatic despite of high dose medication, and experience frequent exacerbations. Allergic severe asthmatics with high serum IgE levels may be responsive to anti-IgE treatment. Omalizumab was administered to 89 allergic severe asthmatics with serum IgE >70 IU/ml. Clinical effectiveness of omalizumab was assessed every 3 months. 92.1% (82/89) of allergic severe asthmatics responded to omalizumab in terms of improvement of asthma control, reduction of ER visit, hospitalization, dosage of steroids. 68.5% (n=61) and 23.6% (n=21) of patients achieved well control and partial control of asthma, respectively after 3 months of treatment. For patients with partial control, 52.4% (n=12) and 33.3% (n=7) attained well control after 3 months of additional itraconazole or rhinosinus surgery, respectively. The effectiveness of omalizumab persisted for 8.8+4.5 months after cessation of >1 year of treatment (n=62), but only 3.2+1.2 months in <1 year of treatment (n=27, P<0.01). Patients who lost their asthma control <6 months after cessation of omalizumab had a lower FEV1 (45+12%predicted, n=28) than those relapsed >12 months (78+14% predicted, n=21, P<0.01) or those relapsed within 6-12 months (62+7.1% predicted, n=40, P<0.05). In conclusion, omalizumab is effective in treatment of allergic severe asthma. Additional anti-fungal therapy or rhinosinus surgery is required for patients with fungus sensitization or rhinosinusitis to achieve well control of asthma. Omalizumab treatment for >1 year may preserve longer effectiveness.