ABSTRACT
Title
The effect of Omalizumab on exacerbation frequency, corticosteroids intake and peripheral blood eosinophils count in atopic asthmatic patients
Authors
L. Gallelli1, G. Pelaia2, P. Romeo2, T. Renda2, M. T. Busceti2, G. Marrazzo2, G. De Sarro1, R. Maselli2
1Chair of Pharmacology, Department of Experimental and Clinical Medicine, School of Medicine, University “Magna Graecia” of Catanzaro, Via T. Campanella 115, 88100 Catanzaro, Italy.
2Chair of Respiratory Diseases, Department of Experimental and Clinical Medicine, School of Medicine, University of Catanzaro, Viale Europa – Germaneto, 88100 Catanzaro, Italy.
1Chair of Pharmacology, Department of Experimental and Clinical Medicine, School of Medicine, University “Magna Graecia” of Catanzaro, Via T. Campanella 115, 88100 Catanzaro, Italy.
2Chair of Respiratory Diseases, Department of Experimental and Clinical Medicine, School of Medicine, University of Catanzaro, Viale Europa – Germaneto, 88100 Catanzaro, Italy.
Abstract
Omalizumab is a humanized monoclonal anti-IgE antibody recently approved for the treatment of severe persistent allergic asthma, which remains inadequately controlled despite optimal therapy with high doses of inhaled corticosteroids and long-acting b2-adrenergic agonists. Within this context, the present observational study refers to 16 patients currently treated with omalizumab at the Respiratory Unit of “Magna Græcia” University Hospital located in Catanzaro,Italy, whose anti-IgE therapy was started in the period included between March 2007 and February 2010, thus lasting at least 10 months. After 40 weeks of add-on treatment with omalizumab, very relevant decreases were detected, in comparison with pre-treatment mean (+ standard deviation) values, in monthly exacerbation numbers (from 1.09 + 0.61 to 0.22 + 0.36) and oral corticosteroid consumption (from 22.6 + 5.04 to 1.25 + 2.89 mg/day of prednisone). These changes were associated with stable improvements in lung function, expressed as increases of both FEV1 (from 53.56% + 14.57 to 77% + 14.94 of predicted values) and FEV1/FVC ratio (from 56.3% + 9.52 to 65.8% + 9.16). Moreover, in 5 patients who persistently had high blood numbers of eosinophils (mean + SD: 15.86% + 7.99 of total WBC count; absolute number: 1588 + 956.9/ml) despite a long-lasting therapy with inhaled and systemic corticosteroids, the peripheral counts of these cells decreased down to normal levels (mean + SD: 6.3% + 2.31 of total WBC count; absolute number: 462 + 262.3/ml) after 16 weeks of treatment with omalizumab. Therefore, this descriptive evaluation confirms the efficacy of add-on omalizumab therapy in selected patients with exacerbation-prone, chronic allergic uncontrolled asthma, requiring a continuous intake of oral corticosteroids.