RT Journal Article
SR Electronic
T1 Omalizumab, airway obstruction and remodeling
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA4901
DO 10.1183/13993003.congress-2016.PA4901
VO 48
IS suppl 60
A1 Bellocchia, Michela Maria
A1 Ambrosanio, Renza
A1 Patrucco, Filippo
A1 Verri, Giulia
A1 Mercante, Lorena
A1 Boita, Monica
A1 Tabbbia, Giuseppe
A1 Mattei, Alessio
A1 Solidoro, Paolo
A1 Bucca, Caterina
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA4901.abstract
AB There is evidence that IgE are implicated in the development of airway remodeling and that it may be attenuated by treatment with anti-IgE omalizumab. We evaluated the effect of omalizumab on airway obstruction, assuming persistent normalization of FEV1 as a marker of remodeling amelioration.Methods- In 24 patients with severe allergic asthma and FEV1 < 80% predicted, 17 women and 7 men, mean age 57 years (range 38-75), we evaluated the median value of FEV1, FeNO, ACT and number of exacerbations (AE) one year before and after omalizumab treatment for six months,1 yr (19 pts), and 2 years (12). Patients were divided into two groups: G1 showing persistent FEV1 normalization after omalizumab and G2 with persistent airway obstruction.Results- Before treatment, G1 and G2 did not differ by FEV1 (63 vs 58 %), total IgE (477 vs 290 UI/L), ACT (15 vs 17) and AE (4.4 vs 4). G1 had significantly higher FENO (73 vs 22 ppb) and eosinophils (0.854 vs 0.348 10^9/L). During treatment, there was a significant increase in ACT, and decrease in AE number in both groups, already evident after 6months. By contrast, FENO and FEV1 and improved only in G1, FEV1 remaining persistently normal, see figure.Conclusions- Our findings support the hypothesis that omalizumab attenuates airway inflammation and remodeling, acting in the first few months of therapy. This effect can be expected in patients with high FENO and eosinophilia before treatment.