Omalizumab in Middle-aged or Older Patients with Severe Allergic Asthma-COPD Overlap

Overview

Journal Postepy Dermatol Alergol

Publisher Termedia

Specialty Allergy & Immunology

Date 2022 Apr 4

PMID 35369622

Authors

Luisa Ricciardi

Francesco Papia

Marta Liotta

Francesca Cicero

Stefania Isola

Gennaro Tartarisco

Fabiana Furci

Sebastiano Gangemi

Affiliations

Soon will be listed here.

Abstract

Introduction: Biological therapies used for severe asthma may be useful even for middle-aged or older patients who have a history of severe allergic asthma with a chronic obstructive pulmonary disease (COPD) overlap phenotype.

Aim: To show omalizumab efficacy in severe allergic asthma-COPD overlap disease.Material and methods: We report our data of a retrospective study on 11 patients (mean age: 67.18 years) with a positive history of severe allergic asthma treated with omalizumab. They all presented limited reversibility of airway obstruction and signs of chronic bronchitis at radiological examinations, as in asthma-COPD overlap. Omalizumab improved conditions in terms of reduced exacerbations as well as asthma control test (ACT) and Asthma Quality of Life Questionnaire (AQLQ) scores.

Results: Clinical improvement was seen already in the first year with significantly increased ACT scores ( < 0.0001) and a significantly decreased number of exacerbations ( < 0.001). Furthermore, our data showed a significant inverse correlation over time between the number of exacerbations and ACT ( = -0.83, < 0.0001), AQLQ symptoms ( = -0.87, < 0.0001), forced expiratory volume in 1 s (FEV) ( = -0.71, < 0.001) and FEV/forced vital capacity (FVC) ( = -0.43, = 0.04). There also was a positive correlation between ACT and FEV ( = 0.74, < 0.0001), ACT and AQLQ symptoms ( = 0.93, < 0.0001), FEV and AQLQ symptoms ( = 0.67, < 0.001). All parameters continued to improve during the second year of treatment.

Conclusions: Omalizumab may be relevant as a therapeutic option even in middle-aged and older patients with severe asthma.

References

Incorvaia C, Ridolo E . In the strategies to prevent asthma exacerbations, allergic asthma needs specific treatment. Curr Med Res Opin. 2015; 31(4):821-3. DOI: 10.1185/03007995.2015.1024215. View

Busse W, Corren J, Lanier B, McAlary M, Fowler-Taylor A, Cioppa G . Omalizumab, anti-IgE recombinant humanized monoclonal antibody, for the treatment of severe allergic asthma. J Allergy Clin Immunol. 2001; 108(2):184-90. DOI: 10.1067/mai.2001.117880. View

Caminati M, Senna G, Guerriero M, Dama A, Chieco-Bianchi F, Stefanizzi G . Omalizumab for severe allergic asthma in clinical trials and real-life studies: what we know and what we should address. Pulm Pharmacol Ther. 2015; 31:28-35. DOI: 10.1016/j.pupt.2015.01.006. View

Jamieson D, Matsui E, Belli A, McCormack M, Peng E, Pierre-Louis S . Effects of allergic phenotype on respiratory symptoms and exacerbations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2013; 188(2):187-92. PMC: 3778754. DOI: 10.1164/rccm.201211-2103OC. View

Toledo-Pons N, van Boven J, Roman-Rodriguez M, Perez N, Valera Felices J, Soriano J . ACO: Time to move from the description of different phenotypes to the treatable traits. PLoS One. 2019; 14(1):e0210915. PMC: 6345463. DOI: 10.1371/journal.pone.0210915. View

Jose Maselli D, Hanania N . Management of asthma COPD overlap. Ann Allergy Asthma Immunol. 2019; 123(4):335-344. DOI: 10.1016/j.anai.2019.07.021. View

Abraham I, Alhossan A, Lee C, Kutbi H, MacDonald K . 'Real-life' effectiveness studies of omalizumab in adult patients with severe allergic asthma: systematic review. Allergy. 2015; 71(5):593-610. DOI: 10.1111/all.12815. View

Bland J, Altman D . Calculating correlation coefficients with repeated observations: Part 1--Correlation within subjects. BMJ. 1995; 310(6977):446. PMC: 2548822. DOI: 10.1136/bmj.310.6977.446. View

Bland J, Altman D . Calculating correlation coefficients with repeated observations: Part 2--Correlation between subjects. BMJ. 1995; 310(6980):633. PMC: 2549010. DOI: 10.1136/bmj.310.6980.633. View

10.

Riccio A, Dal Negro R, Micheletto C, De Ferrari L, Folli C, Chiappori A . Omalizumab modulates bronchial reticular basement membrane thickness and eosinophil infiltration in severe persistent allergic asthma patients. Int J Immunopathol Pharmacol. 2012; 25(2):475-84. DOI: 10.1177/039463201202500217. View

11.

Sala-Cunill A, Bartra J, Dalmau G, Tella R, Botey E, Raga E . Prevalence of asthma and severity of allergic rhinitis comparing 2 perennial allergens: house dust mites and Parietaria judaica pollen. J Investig Allergol Clin Immunol. 2013; 23(3):145-51. View

12.

Moore W, Bleecker E, Curran-Everett D, Erzurum S, Ameredes B, Bacharier L . Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute's Severe Asthma Research Program. J Allergy Clin Immunol. 2007; 119(2):405-13. PMC: 2837934. DOI: 10.1016/j.jaci.2006.11.639. View

13.

Tat T, Cilli A . Omalizumab treatment in asthma-COPD overlap syndrome. J Asthma. 2016; 53(10):1048-50. DOI: 10.1080/02770903.2016.1178281. View

14.

Parulekar A, Diamant Z, Hanania N . Role of biologics targeting type 2 airway inflammation in asthma: what have we learned so far?. Curr Opin Pulm Med. 2016; 23(1):3-11. DOI: 10.1097/MCP.0000000000000343. View

15.

Hanania N, Alpan O, Hamilos D, Condemi J, Reyes-Rivera I, Zhu J . Omalizumab in severe allergic asthma inadequately controlled with standard therapy: a randomized trial. Ann Intern Med. 2011; 154(9):573-82. DOI: 10.7326/0003-4819-154-9-201105030-00002. View

16.

Neves M, Neves Y, Mendes C, Bastos M, Camelier A, Queiroz C . Evaluation of atopy in patients with COPD. J Bras Pneumol. 2013; 39(3):296-305. PMC: 4075840. DOI: 10.1590/S1806-37132013000300006. View

17.

Maltby S, Gibson P, Powell H, McDonald V . Omalizumab Treatment Response in a Population With Severe Allergic Asthma and Overlapping COPD. Chest. 2016; 151(1):78-89. DOI: 10.1016/j.chest.2016.09.035. View

18.

Yousuf A, Ibrahim W, Greening N, Brightling C . T2 Biologics for Chronic Obstructive Pulmonary Disease. J Allergy Clin Immunol Pract. 2019; 7(5):1405-1416. DOI: 10.1016/j.jaip.2019.01.036. View

19.

Kondo M, Tamaoki J . Therapeutic approaches of asthma and COPD overlap. Allergol Int. 2017; 67(2):187-190. DOI: 10.1016/j.alit.2017.09.002. View

20.

Sposato B, Scalese M, Milanese M, Masieri S, Cavaliere C, Ricci A . Should omalizumab be used in severe asthma/COPD overlap?. J Biol Regul Homeost Agents. 2018; 32(4):755-761. View