title: Clinical experience with omalizumab in a Portuguese severe asthma unit.
abstract: BACKGROUND
  It is widely recognized that asthma control is not always possible in patients with very severe asthma despite available treatment. The aim of this study was to evaluate the efficacy of Omalizumab on asthma control as an add-on therapy in patients from the "Severe Asthma Outpatient Clinic" of Pulido Valente Hospital in Lisbon, Portugal.
  
  
  METHODS
  A retrospective study was conducted to assess asthma control by the ACT score and by GINA classification, frequency and severity of exacerbations, medication use and pulmonary function in patients treated with Omalizumab. Clinical information was collected from medical records from the start of treatment and at 6, 12 and 24 month follow-up.
  
  
  RESULTS
  26 patients started treatment with Omalizumab, all (100%) were classified by GINA with uncontrolled asthma prior to treatment. Mean ACT score was 11.5. All patients had treatment with fixed-dose ICS and LABA and 34.6% also had an anti-cholinergic inhaler. 42.3% of patients were also treated with oral glucocorticosteroids for control. Patients reported an average of 1.8 moderate and 3.1 severe exacerbations/year. Statistical differences were found at 6 month follow-up in most end-points: GINA score improved: 60.9% of patients with partially controlled asthma and only 39.1% with uncontrolled asthma (Wilcoxon 0.00); ACT score improved to 19.52 (Wilcoxon 0.00); mean FEV1 improved to 76.7% (Wilcoxon 0.025); the proportion of patients requiring oral glucocorticosteroid therapy reduced to 17.4% (Wilcoxon 0.014); and the number of moderate and severe exacerbations also decreased to 1.04 and 1.83 respectively (Wilcoxon 0.007; Wilcoxon 0.002 respectively).
  
  
  CONCLUSIONS
  The current analysis shows evidence that omalizumab is successful in improving asthma control as an add-on therapy GINA step 5 treatment.
authors: Serviço de Pneumologia, Hospital Pulido Valente, Lisboa, Portugal.
authors: S
authors: S
authors: Alfarroba
authors: Serviço de Pneumologia, Hospital Pulido Valente, Lisboa, Portugal. Electronic address: watsa-1@hotmail.com.
authors: W
authors: W
authors: Videira
authors: Serviço de Pneumologia, Hospital Pulido Valente, Lisboa, Portugal.
authors: C
authors: C
authors: Galvão-Lucas
authors: Serviço de Imunoalergologia, Hospital Pulido Valente, Lisboa, Portugal.
authors: F
authors: F
authors: Carvalho
authors: Serviço de Pneumologia, Hospital Pulido Valente, Lisboa, Portugal.
authors: C
authors: C
authors: Bárbara
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D005260:Female; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab; D011174:Portugal; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab
keywords: Anti IgE; Asma; Asthma; Omalizumab