title: Omalizumab Is Equally Effective in Persistent Allergic Oral Corticosteroid-Dependent Asthma Caused by Either Seasonal or Perennial Allergens: A Pilot Study.
abstract: Omalizumab is marketed for chronic severe asthma patients who are allergic to perennial allergens. Our purpose was to investigate whether omalizumab is also effective in persistent severe asthma due to seasonal allergens. Thirty patients with oral corticosteroid-dependent asthma were treated with Omalizumab according to the dosing table. For each patient with asthma due to seasonal allergens, we recruited the next two consecutive patients with asthma due to perennial allergens. The dose of oral methyl prednisolone was tapered at a rate of 2 mg every two weeks after the start of treatment with omalizumab depending on tolerance. At each monthly visit, a forced spirometry and fractional exhaled nitric oxide (FeNO) measurement were performed and the accumulated monthly methyl prednisolone dose was calculated. At entry, there were no differences between groups in terms of gender, body mass index or obesity, year exacerbation rate, monthly dose of methyl-prednisolone (MP), FeNO and blood immunoglobuline E (IgE) MP, FeNO and IgE values, or spirometry (perennial: FVC: 76%; FEV₁: 62%; seasonal: FVC: 79%; FEV₁: 70%). The follow-up lasted 76 weeks. One patient in each group was considered a non-responder. Spirometry did not worsen in either group. There was a significant intragroup reduction in annual exacerbation rate and methyl prednisolone consumption but no differences were detected in the intergroup comparison. Omalizumab offered the same clinical benefits in the two cohorts regardless of whether the asthma was caused by a seasonal or a perennial allergen. These results strongly suggest that allergens are the trigger in chronic asthma but that it is the persistent exposure to IgE that causes the chronicity.
authors.affiliation: Pulmonary Service, Corporació Sanitària Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain. cdomingo@tauli.cat.|Department of Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), Av. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain. cdomingo@tauli.cat.
authors.forename: Christian
authors.initials: C
authors.lastname: Domingo
authors.affiliation: Pulmonary Service, Corporació Sanitària Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain. jpomares@tauli.cat.|Department of Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), Av. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain. jpomares@tauli.cat.|CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain. jpomares@tauli.cat.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pomares
authors.affiliation: Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), Av. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain. Albert.navarro@uab.cat.
authors.forename: Albert
authors.initials: A
authors.lastname: Navarro
authors.affiliation: Department of Pharmacy, Corporació Sanitària Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain. nrudi@tauli.cat.
authors.forename: Núria
authors.initials: N
authors.lastname: Rudi
authors.affiliation: Pulmonary Service, Corporació Sanitària Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain. asogo@tauli.cat.|Department of Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), Av. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain. asogo@tauli.cat.
authors.forename: Ana
authors.initials: A
authors.lastname: Sogo
authors.affiliation: Allergy Service, University Hospital of Salamanca, Biomedical and diagnostics sciences, Universidad de Salamanca, 37008 Salamanca, Spain. idg@usal.es.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Dávila
authors.affiliation: Department of Morphological Sciences, Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), Av. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain. Rosa.mirapeix@uab.cat.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Mirapeix
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D018450:Disease Progression; D004804:Eosinophils; D045853:Exhalation; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D000069444:Omalizumab / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012129:Respiratory Function Tests; D012621:Seasons; D012720:Severity of Illness Index; D012882:Skin Tests; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000485:Allergens; D018927:Anti-Asthmatic Agents; D000069444:Omalizumab; D009569:Nitric Oxide; D007073:Immunoglobulin E
keywords: omalizumab; pathophysiology; perennial; seasonal; severe allergic asthma