title: Omalizumab in the treatment of allergic bronchopulmonary aspergillosis: One center's experience with 14 cases.
abstract: BACKGROUND
  Omalizumab has been a valuable option for patients with severe allergic asthma, but there are only case reports regarding effectiveness of omalizumab in patients with allergic bronchopulmonary aspergillosis (ABPA).
  
  
  OBJECTIVE
  To evaluate the clinical and functional effectiveness of omalizumab in patients with asthma and ABPA in long-term follow-up.
  
  
  METHODS
  The study was conducted as a retrospective chart review of patients with ABPA who were treated with omalizumab injections between December 2008 and June 2014. Once treatment with omalizumab was started, data were collected at three time points: at baseline, after 1 year, and, in June 2014, at the last follow-up.
  
  
  RESULTS
  Fourteen patients with ABPA (seven women and seven men; mean [± standard deviation (SD)] age, 44.21 ± 13.01 years) were included. The treatment period was 31.5 ± 3.99 months (mean ± SD). The difference between the baseline and the last evaluation of the mean percentage of forced expiratory volume in 1 second (FEV1) was significant (p = 0.02). The mean asthma control test score was increased at all-time points compared with the basal score (p = 0.001). After omalizumab treatment was initiated, the patients' mean oral corticosteroid dosage significantly decreased (p = 0.001). The baseline exacerbation rate was 2.7 ± 1.5/y (mean ± SD), and the hospitalization rate was 1.4/y, and both were zero at the last assessment (p = 0.001). Eleven of the patients (78.6%) responded perfectly, and three (21.4%) partially responded to treatment. The patients who had a total immunoglobulin E level of <1000 IU/mL seemed to be more responsive than those whose total immunoglobulin E level was >1000 IU/mL (p = 0.05).
  
  
  CONCLUSIONS
  Omalizumab provided a clinically important reduction in exacerbations and steroid requirement, and improved asthma symptoms and pulmonary function parameters in patients with asthma and ABPA who had previously shown an unsatisfactory response to Global Initiative for Asthma step 4 treatment.
authors.affiliation: Division of Immunology and Allergy, Department of Chest Disease, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Ömür
authors.initials: Ö
authors.lastname: Aydın
authors.forename: Zeynep Çelebi
authors.initials: ZÇ
authors.lastname: Sözener
authors.forename: Şadan
authors.initials: Ş
authors.lastname: Soyyiğit
authors.forename: Reşat
authors.initials: R
authors.lastname: Kendirlinan
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Gençtürk
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Mısırlıgil
authors.forename: Dilşad
authors.initials: D
authors.lastname: Mungan
authors.forename: Betül Ayşe
authors.initials: BA
authors.lastname: Sin
authors.forename: Yavuz Selim
authors.initials: YS
authors.lastname: Demirel
authors.forename: Gülfem Elif
authors.initials: GE
authors.lastname: Çelik
authors.forename: Sevim
authors.initials: S
authors.lastname: Bavbek
mesh_terms: D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D000908:Antibodies, Fungal / Q000276:immunology; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000627:therapeutic use*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents; D000908:Antibodies, Fungal; D000069444:Omalizumab; D007073:Immunoglobulin E