title: Anti-IgE Monoclonal Antibody (Omalizumab) in Refractory and Relapsing Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss): Data on Seventeen Patients.
abstract: To describe the efficacy and safety of omalizumab, an anti-IgE monoclonal antibody, in patients with refractory and/or relapsing eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA).
  
  
  
  We conducted a nationwide retrospective study including EGPA patients who received omalizumab. Response was defined as the absence of asthma and/or sinonasal exacerbations with a prednisone dosage of ≤7.5 mg/day (complete response) or >7.5 mg/day (partial response).
  
  
  
  Seventeen patients (median age 45 years) received omalizumab for severe steroid-dependent asthma (88%) and/or sinonasal involvement (18%). After a median follow-up of 22 months, 6 patients (35%) achieved a complete response, 5 patients (30%) achieved a partial response, and 6 patients (35%) had no improvement. The median Birmingham Vasculitis Activity Score decreased from 2.5 at baseline to 0.5 at 12 months. The median number of exacerbations per month decreased from 1 at baseline to 0 at 12 months, and the median forced expiratory volume in 1 second increased from 63% of the percent predicted at baseline to 85% of the percent predicted at 12 months. The median prednisone dosage decreased from 16 mg/day at baseline to 11 mg/day at 6 months and 9 mg/day at 12 months. Omalizumab was discontinued in 8 patients (47%) during follow-up, because of remission (12.5%), adverse event despite disease remission (12.5%), refractory disease (25%), or relapse (50%). Relapses included retrobulbar optic neuritis attributable to EGPA in 2 patients and severe asthma flare in 2 others.
  
  
  
  The results of this study suggest that omalizumab may have a corticosteroid-sparing effect in EGPA patients with asthmatic and/or sinonasal manifestations, but reducing the corticosteroid dose may also increase the risk of severe EGPA flares, which raises the question of the safety of omalizumab in patients with EGPA.
authors.affiliation: National Referral Center for Systemic and Autoimmune Diseases, Hôpital Cochin, AP-HP, and Université Paris Descartes, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Jachiet
authors.affiliation: Centre Hospitalier Universitaire (CHU) de Dijon, Dijon, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Samson
authors.affiliation: Hôpital Edouard Herriot Herriot, Lyon, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Cottin
authors.affiliation: Hôpital Foch, Université Versailles Saint-Quentin en Yvelines, Suresnes, France.
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: Kahn
authors.affiliation: Hôpital Estaing, Clermont-Ferrand, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Le Guenno
authors.affiliation: National Referral Center for Systemic and Autoimmune Diseases, Hôpital Cochin, AP-HP, and Université Paris Descartes, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bonniaud
authors.affiliation: Centre Hospitalier Universitaire (CHU) de Dijon, Dijon, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Devilliers
authors.affiliation: CHU de Grenoble and Michallon Hospital, Grenoble, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bouillet
authors.affiliation: CHU de Besançon, Besançon, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Gondouin
authors.affiliation: CHU de Grenoble and Michallon Hospital, Grenoble, France.
authors.forename: Fatma
authors.initials: F
authors.lastname: Makhlouf
authors.affiliation: CHU de Besançon, Besançon, France.
authors.forename: Nadine
authors.initials: N
authors.lastname: Meaux-Ruault
authors.affiliation: CHU de Besançon, Besançon, France.
authors.forename: Helder
authors.initials: H
authors.lastname: Gil
authors.affiliation: CHU de Caen, Caen, France.
authors.forename: Boris
authors.initials: B
authors.lastname: Bienvenu
authors.affiliation: Hôpital Intercommunal, Créteil, France.
authors.forename: André
authors.initials: A
authors.lastname: Coste
authors.affiliation: National Referral Center for Systemic and Autoimmune Diseases, Hôpital Cochin, AP-HP, and Université Paris Descartes, Paris, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Groh
authors.affiliation: Hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France.
authors.forename: Violaine
authors.initials: V
authors.lastname: Giraud
authors.affiliation: CHU de Rouen, Rouen, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Dominique
authors.affiliation: Hôpital Henri Mondor, AP-HP, Créteil, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Godeau
authors.affiliation: National Referral Center for Systemic and Autoimmune Diseases, Hôpital Cochin, AP-HP, and Université Paris Descartes, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Puéchal
authors.affiliation: Centre Hospitalier Universitaire (CHU) de Dijon, Dijon, France.
authors.forename: Chahera
authors.initials: C
authors.lastname: Khouatra
authors.affiliation: Hôpital Estaing, Clermont-Ferrand, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Ruivard
authors.affiliation: National Referral Center for Systemic and Autoimmune Diseases, Hôpital Cochin, AP-HP, and Université Paris Descartes, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Le Jeunne
authors.affiliation: National Referral Center for Systemic and Autoimmune Diseases, Hôpital Cochin, AP-HP, and Université Paris Descartes, Paris, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Mouthon
authors.affiliation: National Referral Center for Systemic and Autoimmune Diseases, Hôpital Cochin, AP-HP, and Université Paris Descartes, Paris, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Guillevin
authors.affiliation: National Referral Center for Systemic and Autoimmune Diseases, Hôpital Cochin, AP-HP, and Université Paris Descartes, Paris, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Terrier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000150:complications / Q000188:drug therapy; D015267:Churg-Strauss Syndrome / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018926:Anti-Allergic Agents; D000069444:Omalizumab