Abstract

Background: Omalizumab is approved as add-on therapy for the treatment of severe uncontrolled allergic asthma. Increase in quality of life and decrease of exacerbations and hospital admissions, as well as immunmodulatory effects have been described with Omalizumab therapy. However, to date there are little parameters to monitor success and to evaluate the individual advantage of this therapy for the patient. Furthermore no reliable parameter to predict response to treatment exists so far. Aim of this study was to define an easily applicable parameter for response to treatment with Omalizumab.
Method: 43 patients with allergic asthma were treated with Omalizumab at a dose of at least 0,016 mg/ kg/IgE every 4 weeks. Before and 12 weeks after initiation of therapy, bodyplethysmography including airway resistance was performed. Efficacy of treatment was judged by the attending physician on the basis of a five point chart. Furthermore a differential blood count was performed before and 12 weeks after initiation of treatment. Total and specific IgE against all relevant antigens were determined before start of therapy.
Results: Airway resistance in patients with response to treatment with Omalizumab (responder), was significantly decreased in comparison to patients without clinical benefit (non-responder). The number of eosinophil granulocytes in the peripheral blood was decreased in both groups without significant difference. Response to therapy was associated with younger age and lower levels of specific IgE against the allergen with the highest sIgE-level (seasonal and perennial), but not with the sIgE level of the perennial allergens in general.
Conclusion: Measurement of airway resistance might be an additional parameter to monitor response to therapy with Omalizumab. High specific IgE levels, for both perennial and concornitant seasonal allergens and increasing age seem to predict less favorable treatment outcomes.

German version published in Allergologie, Vol. 34, No. 6/2011, pp. 299-306

Author Details

Authors

• M. Probst²
• A. Gogolka²
• M. Krüll^{1, 2}
• O. Noga^{1, 2}

Departments

• ¹ Institute of Allergy and Asthma Research Berlin,
• ² Medical Clinical for Infectiology/Pulmonology, Charité – Universitätsmedizin Berlin

Address

Dr. med. O. Noga
Institut für Allergie- und Asthmaforschung Berlin IAAB
Tempelhofer Damm 176
D–12099 Berlin
Email: [email protected]

Citation