Subcutaneous specific immunotherapy (SCIT) added to omalizumab in severe allergic asthma patients -efficacy and safety M.Christopoulou, J.Moisidis, L.Panteli and A.Christopoulos  Asthma Clinics Private outpatient clinic Patras/Greece

Abstract

SCIT is not indicated in severe allergic asthma,due to the fear of worsening of asthma control. However,biologics demostrate significant asthma control improvment. This may provide the opportunity to combine SCIT with biologics in pt with severe allergic asthma. The aim of this study was to asses clinical efficacy, tolerability and safety of SCIT combined with omalizumab in pts with severe allergic asthma. Method. A total of 35 adults,followed already in our center for at least 12 months,with history of early onset asthma,demonstrating allergic sensitization to dust mites and lack of asthma control,despite conventional stage 4 treatment,not depended on OCS,eligible for omalizumab,were included. After an initial 4 month treatment period with omalizumab patients were reassessed. Those achieving asthma control,were initiated additional SCIT with a glutaraldehyde-modified mixture of Dermatophagoides according to a standard protocol. Pts were assessed at 3 time points:BaselineT1,after 4 months under omalizumabT2and after 8 months under combined therapyT3. T2 30 pts,achieved asthma control and continued with add on SCIT. T3pts experienced a significant decrease in exacerbation/12 months 2.8±1.8vs0.9±0.7,p<0.001,an increment of ACT 13±2.7vs22.9±2.3, p<0.001,an increase in per-bronchodialtor FEV1 1.94±0.450vs1.56±0.320,p<0.001 while the number of CSEs demanding OCS significantly decreased. The above results suggest that when SCIT is combined with omalizumab is an efficacious and safe therapeutic strategy even in severe allergic asthma,deserving further investigation.