Omalizumab in non-conventional clinical indications: our case series

Author:

Arasi, S 1,2; Pajno, GB 1; Costa, S 3; Caminiti, L 1; Crisafulli, G 1; Porcaro, F 1

Author address:

1 Allergy Unit-Department of Pediatrics, University of Messina, Messina, Italy; 2 Department of Pediatric Pneumology and Immunology, Charite Medical University, Berlin, Germany; 3 Gastroenterology Unit Department of Pediatrics, University of Messina, Messina, Italy

Full conference title:

European Academy of Allergy and Clinical Immunology Congress 2016

Abstract:

Background: Omalizumab is an anti-IgE antibody approved for severe asthma and chronic idiopathic urticaria unresponsive to conventional treatments. A few data report use of omalizumab in other IgE- and not-IgE-mediated diseases with controversial results. We report our experience.

Method: Omalizumab was performed at anti-asthmatic posology in all patients; at dosage for chronic idiopathic urticaria in the patient with solar urticaria (from 5th dose).

Results: A 15-year-old female, with solar urticaria unresponsive to a combination of conventional treatments and a quality of life seriously compromised, after the second injection of omalizumab presented a clinical remission of symptoms. She currently is under treatment successfully with omalizumab. In a 13-year-old boy with severe persistent allergic asthma and concomitant eosinophilic esophagitis, omalizumab resulted efficacy on asthma, according to its conventional indication, but it did not produce persistent clinical improvement nor endoscopic and histological changes of esophagitis. Three young adults (18, 21, 26 years of age) with cystic fibrosis started omalizumab in order to better control allergic broncopulmonary aspergillosis. All patients were treated with concomitant high dose steroids and two of them were on antimycothic therapy. They presented high titers of RAST for Aspergillus fumigatus (average 1062 KU/ml), and asthma-like symptoms. After two months of treatment, patients improved clinically, IgE titers decreased (average 500 KU/ml) and steroids were successfully tapered. No spirometric modifications were observed during follow up.

Conclusions : Our case series contribute: to shed light on new further possible mechanisms of action omalizumab; new clinical indications to this treatment; better select patients who may benefit from this treatment.

Abstract Number: 1329

Conference Year: 2016

Link Conference abstract: 

EAACI 2016

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