title: Impact of omalizumab therapy on medication requirements for chronic rhinosinusitis.
abstract: Omalizumab is indicated for treatment of patients with moderate to severe allergic asthma. Previous studies have shown 70% of these patients also have chronic rhinosinusitis (CRS). The present series examines the impact of omalizumab on medication use for CRS in a cohort of asthmatic CRS patients who received this therapy.
  
  
  
  The sample included 25 patients with adequate prescription data preinitiation and postinitiation of therapy. Data was available for a full 12 months both preinitiation and postinitiation of therapy in 20 of 25 patients and for 4 to 8 months in the remaining 5 of 25. Average antibiotic use (# of unique prescriptions per month) and systemic steroid dose (mg/month) were tabulated for each patient and compared before and after initiation of therapy.
  
  
  
  Mean antibiotic prescriptions/month decreased by 37%, and this was statistically significant (p = 0.013). Antibiotic use decreased in 15 of 25 (60%), was the same in 7 of 25 (28%), and increased in 3 of 25 (12%) patients. Chronic steroid administration was required in 19 of 25 patients, and dosing was highly variable. Mean monthly steroid dose decreased substantially in 8 of 19 (42%) patients, with reduction ranging from 40% to 100% from pretreatment levels. A modest decrease of 17% to 30% was observed in 4 of 19 (21%) patients. Steroid use was essentially unchanged in 4 of 19 (21%), but dramatically increased (71% to 366% above pretreatment dose) in 3 of 19 (15%) patients.
  
  
  
  Omalizumab therapy is associated with a decrease in overall antibiotic use for CRS. A subset of patients also experience significant reduction in steroid dependence. Further study is necessary to determine factors predictive of response.
authors.affiliation: Vanderbilt Asthma, Sinus, and Allergy Partnership, Vanderbilt University, Nashville, TN.
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Chandra
authors.affiliation: Vanderbilt Asthma, Sinus, and Allergy Partnership, Vanderbilt University, Nashville, TN.
authors.forename: Matthew
authors.initials: M
authors.lastname: Clavenna
authors.affiliation: Vanderbilt Asthma, Sinus, and Allergy Partnership, Vanderbilt University, Nashville, TN.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Samuelson
authors.affiliation: Vanderbilt Asthma, Sinus, and Allergy Partnership, Vanderbilt University, Nashville, TN.
authors.forename: S Bobo
authors.initials: SB
authors.lastname: Tanner
authors.affiliation: Vanderbilt Asthma, Sinus, and Allergy Partnership, Vanderbilt University, Nashville, TN.
authors.forename: Justin H
authors.initials: JH
authors.lastname: Turner
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000627:therapeutic use*; D012220:Rhinitis / Q000188:drug therapy*; D012852:Sinusitis / Q000188:drug therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D018926:Anti-Allergic Agents; D018927:Anti-Asthmatic Agents; D000900:Anti-Bacterial Agents; D000069444:Omalizumab
keywords: IgE; Xolair; anti-IgE; asthma; chronic sinusitis; omalizumab