Abstract
The treatment with anti-IgE monoclonal antibody omalizumab is approved for severe allergic asthma (SAA) and chronic spontaneous urticaria. However, the effectiveness of omalizumab has been observed also in other IgE-mediated diseases.
The aim of this study was to evaluate the effect of omalizumab on SAA and other allergic comorbidities in the group of patients treated with omalizumab for SAA enrolled in the Czech Anti-IgE Registry (CAR). 310 patients with SAA treated with omalizumab were enrolled to the CAR in 10 specialised centres in the Czech Republic between the years 2006 and 2015. 229 individuals were evaluated after 12 months of omalizumab therapy for asthma control test (ACT), examination of fractional exhaled nitric oxide (FENO), forced expiratory volume in 1 second (FEV1), the use of systemic corticosteroids, side effects of therapy and clinical effect of omalizumab on allergic comorbidities - allergic rhinitis (n = 203), atopic dermatitis (n = 67), food allergy (n = 58), and chronic urticaria (n = 14). A significant improvement of ACT and FEV1, reduction of FENO, use of systemic corticosteroids for asthma exacerbations and dose of maintenance oral corticosteroid therapy were observed after 12 months of treatment with omalizumab.
The positive effect of therapy was observed in 82.2% of patients with allergic rhinitis (improvementin 63.5% of patients, complete remission in 18.7% of patients). 46.3% of patients with atopic dermatitis experienced improvement of symptoms and in 35.8% of patients atopic dermatitis completely resolved. In 35.7% of patients, chronic urticaria disappeared during the therapy with omalizumab and it improved in 50.0% of patients.
Complete remission of food allergy was reported in 39.7% of patients and improvement in 27.6% of patients. In the CAR registry, patients with SAA treated with omalizumab showed a significant positive effect of anti-IgE therapy not only on the asthma control, but also on allergic comorbidities.
The majority of patients with allergic rhinitis, atopic dermatitis, chronic urticaria and food allergy experienced improvement or complete remission of symptoms. The lowest effectiveness of omalizumab treatment was observed in food allergy.