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Omalizumab’s effectiveness in severe allergic asthma and nasal polyps: a real-life study

Tiotiu A1,2, Oster JP3, Roux P4, Nguyen Thi PL5, Peiffer G6, Bonniaud P7,8,9, Dalphin JC4,10, de Blay F11,12

1Department of Pulmonology, University Hospital of Nancy, France
2EA 3450 DevAH - Development, Adaptation and Disadvantage. Cardio-respiratory regulations and motor control. University of Lorraine, Nancy, France
3Department of Pulmonology, Hospital of Colmar, France
4Department of Pulmonology, University Hospital of Besançon, France
5Centre hospitalier universitaire de Nancy, Plateforme d’aide à la recherche clinique, 54000 Nancy, France
6Department of Pulmonology, Hospital of Metz-Thionville, France
7Department of Pulmonary Medicine and Intensive Care Unit, University Hospital, Dijon, France
8Inserm, LNC UMR866, LipSTIC LabEx team, Dijon, France
9Bourgogne Franche-Comté University, Dijon, France
10Franche-Comté University, Besançon, France
11Department of Pulmonology-Allergology, University Hospital of Strasbourg, France
12University of Strasbourg, Strasbourg, France

J Investig Allergol Clin Immunol 2020; Vol. 30(1)
doi: 10.18176/jiaci.0391

Background: Omalizumab is a human anti-IgE antibody approved for the treatment of severe allergic asthma (SAA), but its effectiveness when a chronic rhinosinusitis with nasal polyposis (CRSNP+) is associated is less documented.
Objective: The aim of this study was to evaluate in real-life the effectiveness of omalizumab in patients with SAA and CRSNP+ with or without aspirin intolerance.
Methods: A retrospective, observational, multicentric real-life study was realized including patients with SAA and CRSNP+ treated by omalizumab for 6 months. Asthma outcome parameters (symptoms, number of salbutamol rescue/week, number of moderate/severe exacerbations, Asthma Control Test score, and lung function), sino-nasal outcome parameters (symptoms, number of acute rhinosinusitis, sinus computed tomographic images, nasal endoscopy polyps score), and serum eosinophils levels have been analysed before and after 6 months of treatment by omalizumab.
Results: Twenty-four adult patients were included (nine with a documented aspirin intolerance). All respiratory parameters were significantly improved by the treatment. In parallel, the sino-nasal clinical outcomes and the sinus computed tomographic images were significantly improved without an important effect on the nasal endoscopy polyps score. The serum levels of eosinophils were significantly decreased after 6 months of treatment by omalizumab.
Conclusion: The treatment by omalizumab in SAA improves the associated CRSNP+ outcomes supporting the concept of the one airway disease. 

Key words: Severe allergic asthma, CRSNP+, Omalizumab effectiveness