title: Omalizumab therapy for refractory allergic fungal rhinosinusitis patients with moderate or severe asthma.
abstract: OBJECTIVE
  1. To assess the efficacy of omalizumab therapy in improving sinonasal outcomes in refractory allergic fungal rhinosinusitis (AFRS) patients with moderate or severe asthma. 2. To determine if omalizumab therapy reduces the usage of corticosteroids or antifungal therapy in AFRS patients
  
  
  METHODS
  
  
  
  METHODS
  The clinical charts of patients with AFRS with moderate or severe asthma who received at least three subcutaneous injections of omalizumab therapy between 1st January 2012 and 1st May 2014 were retrospectively reviewed. These patients had undergone bilateral functional endoscopic sinus surgery (FESS) and failed adjunct medical treatments (oral or topical corticosteroids and/or antifungal therapy) prior to omalizumab therapy.
  
  
  RESULTS
  Seven patients met the inclusion criteria and were included in this study. The mean age of the patients was 48.14. The average number of subcutaneous omalizumab injections was 7.57 (range 6-11) with a mean dosage of 287mg (range 225-375mg). The mean pre-omalizumab treatment Sino-Nasal Outcome Test-22 (SNOT-22) score was 52.14 while the mean post-omalizumab treatment SNOT-22 score was 35.86 (31% improvement). The mean pre-omalizumab therapy Phillpott-Javer endoscopic score (over the last one year before omalizumab therapy) was 36 while the mean post-omalizumab therapy endoscopic score (from the last clinic visit) was 14 (61% improvement). Omalizumab therapy reduced the dependence of AFRS patients on corticosteroid and antifungal treatments.
  
  
  CONCLUSIONS
  Omalizumab therapy can be considered as a potential adjunct for the treatment for patients with refractory AFRS with moderate or severe asthma. However, larger prospective studies to confirm the findings of this study will be required.
authors.affiliation: Division of Otolaryngology, University of British Columbia, St. Paul's Sinus Centre, 1081 Burrard St., Vancouver, British Columbia, Canada; Department of Otolaryngology-Head & Neck Surgery, Changi General Hospital, 2 Simei Street 3, Singapore. Electronic address: engcern@gmail.com.
authors.forename: Eng Cern
authors.initials: EC
authors.lastname: Gan
authors.affiliation: Division of Otolaryngology, University of British Columbia, St. Paul's Sinus Centre, 1081 Burrard St., Vancouver, British Columbia, Canada.
authors.forename: Al-Rahim R
authors.initials: AR
authors.lastname: Habib
authors.affiliation: Division of Otolaryngology, University of British Columbia, St. Paul's Sinus Centre, 1081 Burrard St., Vancouver, British Columbia, Canada.
authors.forename: Alykhan
authors.initials: A
authors.lastname: Rajwani
authors.affiliation: Division of Otolaryngology, University of British Columbia, St. Paul's Sinus Centre, 1081 Burrard St., Vancouver, British Columbia, Canada.
authors.forename: Amin R
authors.initials: AR
authors.lastname: Javer
mesh_terms: D018926:Anti-Allergic Agents / Q000008:administration & dosage; D001249:Asthma / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000008:administration & dosage*; D012189:Retrospective Studies; D065631:Rhinitis, Allergic / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents; D000069444:Omalizumab