Source: Annual Congress 2008 - Improving asthma and anti-allergic therapy
Disease area: Airway diseases

Abstract

Introduction: Omalizumab is licensed as add-on therapy for severe persistent allergic (IgE mediated) asthma. Treatment is expensive and 4 months treatment is required before assessing response. The INNOVATE study reported a response rate of 60%.¹
Aim: To determine if a difficult asthma protocol might help to select patients for treatment.
Methods: Retrospective review of patients considered for and treated with Omalizumab in Leeds. Response was defined as complete control or markedly improved control at 4 months.
Results: 23 patients who were initially assessed as suitable for therapy were put through the protocol. Alternative/additional diagnosis was made in 12 (52.1%) patients e.g. vocal cord dysfunction, sleep apnoea, bronchomalacia, sarcoidosis, which precluded using omalizumab, saving almost £60,000 in drug costs for a 4 month trial. To date, 9 patients (8 female), mean age 37 years (16-50) with a mean FEV₁ of 58% (34-88%) and mean IgE 284 iu/mL have been treated for >4 months. All patients considered at risk for a near-fatal asthma attack. 2 patients stopped treatment within 4 months due to adverse events (headache and dizziness) and 6/7 (86%) responded to treatment. Hospital admissions were reduced in 3 patients, whilst the other 3 were low users of hospital services prior to treatment. Asthma control improvement included reduced peak flow variability in all patients and less night waking in 5/6 patients. Reduced rescue medication use and oral steroid dose was achieved in 5 and 3 patients respectively.
Conclusions: Response rate to Omalizumab may be higher than that reported in the INNOVATE study if patients are selected using a difficult asthma protocol.
Reference:
Humbert M, et al. Allergy 2005:60:309-16.

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Citations should be made in the following way:
H. McLoughlin, A. Hart-Thomas, J. Slough, T. Capstick (Leeds, United Kingdom). Use of a protocol to select patients for omalizumab treatment. Eur Respir J 2008; 32: Suppl. 52, 2014

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