Effectiveness of the Polish program for the treatment of severe allergic asthma with omalizumab: a single-center experience.
BACKGROUND
A national program for the treatment of severe allergic (IgE-dependent) asthma with omalizumab (OMA) was implemented in Poland in 2013. This observational study evaluated the effectiveness of the Polish OMA program and monitored asthma control after treatment discontinuation.


METHODS
In the first year of the program, 53 patients (23 new/30 continuing treatment) received OMA in the Barlicki Hospital, Poland. Patients were evaluated at baseline and after 16 weeks of OMA treatment by spirometry, mean dose of inhaled corticosteroids (ICS) and oral corticosteroids (OCS), number of asthma exacerbations, the Asthma Control Questionnaire (ACQ), and the Asthma Quality of Life Questionnaire (AQLQ). OMA treatment responses were determined using the global effectiveness of treatment evaluation scale. Fourteen patients ceased OMA treatment following ≥36 months of therapy and entered follow up.


RESULTS
All patients treated with OMA de novo for at least 16 weeks had a decrease in asthma exacerbations and showed a good (15/16, 94 %) or an excellent (1/16, 6 %) response to treatment. We observed a reduction in OCS dose (≥5 mg/day) in 14/16 (88 %) patients. ACQ and AQLQ scores improved by ≥0.5 points in 15/16 (94 %) and 14/16 (88 %) patients, respectively. After OMA cessation, 11/14 (79 %) patients showed worsening of asthma control and severe exacerbations.


CONCLUSIONS
Patients in the OMA program show significant benefits, including reduced use of OCS, improved asthma control and quality of life. After OMA discontinuation, frequent severe exacerbations were observed primarily in patients whose asthma was previously uncontrolled by high OCS doses.
Department of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Kopcińskiego 22, 90-153, Łódź, Poland. izabela.kuprys-lipinska@umed.lodz.pl.
Izabela
I
Kupryś-Lipińska
Department of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Kopcińskiego 22, 90-153, Łódź, Poland.
Paweł
P
Majak
Department of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Kopcińskiego 22, 90-153, Łódź, Poland.
Joanna
J
Molinska
Department of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Kopcińskiego 22, 90-153, Łódź, Poland.
Piotr
P
Kuna
D000293:Adolescent; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000008:administration & dosage*; D011044:Poland; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
D018927:Anti-Asthmatic Agents; D000069444:Omalizumab
Effectiveness; Omalizumab; Severe asthma; Severe asthma exacerbations