title: Omalizumab in patients with eosinophilic granulomatosis with polyangiitis: a 36-month follow-up study.
abstract: OBJECTIVE
  Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis characterized by asthma and blood eosinophilia, with the lung being the organ most frequently affected. Oral glucocorticoids and/or immunosuppressive drugs are the mainstay therapy of EGPA. Occasional reports suggest that EGPA patients can be treated with omalizumab in addition to conventional therapy to achieve asthma control. To investigate the long-term effects of omalizumab in patients with EGPA and asthma (2 females, 3 males, age 41-64 years), we carried out a 36-month follow-up observational study. At the time of enrollment, the patients were on maintenance therapy and had moderate to severe allergic asthma, eosinophilia and rhinosinusitis. Mononeuropathy/polyneuropathy and/or histological evidence of tissue eosinophilic infiltration were also present.
  
  
  METHODS
  Patients were treated with omalizumab (300-600 mg s.c. every 2-4 weeks) as add-on therapy to prednisone, inhaled steroids and bronchodilators. During omalizumab treatment, spirometry, the asthma control test (ACT) score and eosinophilia were evaluated, and prednisone dosage was recorded.
  
  
  RESULTS
  During the 36 months of omalizumab treatment asthma progressively improved as indicated by spirometry and the ACT score. Eosinophilia progressively decreased. The oral prednisone dose was reduced or withdrawn during treatment. No adverse events were recorded.
  
  
  CONCLUSIONS
  In patients with EGPA and moderate to severe allergic asthma, omalizumab can be beneficial and safe. It enables corticosteroid tapering while decreasing eosinophilia and improving asthma symptoms over 36 months.
authors.affiliation: a Department of Translational Medical Sciences .
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Detoraki
authors.affiliation: a Department of Translational Medical Sciences .
authors.forename: Lorena
authors.initials: L
authors.lastname: Di Capua
authors.affiliation: a Department of Translational Medical Sciences .
authors.forename: Gilda
authors.initials: G
authors.lastname: Varricchi
authors.affiliation: a Department of Translational Medical Sciences .|b Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II , Naples , Italy , and.
authors.forename: Arturo
authors.initials: A
authors.lastname: Genovese
authors.affiliation: a Department of Translational Medical Sciences .|b Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II , Naples , Italy , and.|c CNR Institute of Experimental Endocrinology and Oncology "G. Salvatore" , Naples , Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Marone
authors.affiliation: a Department of Translational Medical Sciences .|b Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II , Naples , Italy , and.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Spadaro
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume; D005938:Glucocorticoids / Q000627:therapeutic use; D014890:Granulomatosis with Polyangiitis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000627:therapeutic use*; D011241:Prednisone / Q000627:therapeutic use; D013147:Spirometry; D016896:Treatment Outcome
chemical_list: D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids; D000069444:Omalizumab; D011241:Prednisone
keywords: Case reports; control/management; morbidity and mortality; pharmacotherapy; therapy