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Colegio de Medicina Interna de México.

2015, Number 6

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Med Int Mex 2015; 31 (6)

Omalizumab in the treatment of persistent moderate to severe asthma in the context of allergic and not allergic asthma

Herrera-García JC, Sánchez-Casas GA, Arellano-Jaramillo LE, Lechuga-Hernández S, Carreto-Sulvaran C, Arellano-Montellano EI, Contreras-Andrade RI

Language: Spanish
References: 26
Page: 693-700
PDF size: 570.68 Kb.


ABSTRACT

Background: Omalizumab in treating persistent moderate to severe asthma is clearly documented in patients difficult to control, reducing morbidity and absenteeism.
Objective: To describe the clinical efficacy of omalizumab in patients older than 18 years with phenotype allergic and non-allergic asthma, poorly controlled symptoms, FEV1 less than 80%, IgE between 30 and 700 IU/mL and testing skin positive or negative in two referral hospitals in the city of Puebla, Mexico.
Material and method: A prospective observational study with patients who were treated with omalizumab in asthma allergic indication or no moderate to severe persistent allergic from January 2014 to January 2015. Age, sex, weight, and IgE reactivity were recorded in vitro to perennial allergens, FEV1, basic treatment, asthma exacerbations and the need for systemic corticosteroids or revenue emergencies, symptoms daytime or nighttime awakenings originated at the beginning of treatment and at 8, 16, 32 and 52 weeks. Side effects and changes in base treatment were collected.
Results: 35 patients with a mean weight of 67.3 kg (89-55 kg). The baseline IgE before the start of omalizumab was 202.5 IU/mL (10-564 IU/mL); 35 patients had reduced lung function with a FEV1 at baseline average of 67% (54-78%). FEV1 at 8 weeks was 67.5% (55-79%) and FEV1 at 52 weeks was 73% (70-80%). The mean dose of omalizumab administered every 30 days was 222.8 mg (150-450). Adverse reactions were observed in 7 patients, none required discontinuation of therapy; 23 patients had positive skin tests and 12 patients had negative skin tests. At the end of follow-up period 20 patients had decreased control treatment (11 patients with allergic asthma and 9 non-allergic asthma patients); 28 patients showed overall improvement, 18 patients in the context of allergic asthma and 10 patients in the context of non-allergic asthma.
Conclusion: Omalizumab produced improvement in non-allergic phenotype (via dendritic cells). In both groups it was observed decreased number of exacerbations and emergency room visits; 93% of patients had overall improvement by clinical criteria and not statistically significant in FEV1 changes were observed, thus, it is concluded that improvement is given in the clinical setting and the quality of life of patients.


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