Case series of omalizumab for allergic bronchopulmonary aspergillosis in cystic fibrosis patients

Summary Allergic bronchopulmonary aspergillosis (ABPA) affects up to 15% of patients with cystic fibrosis (CF). Corticosteroids are used as first‐line therapy, but relapse and adverse effects commonly occur. Case reports have suggested the efficacy of the anti‐IgE recombinant humanized monoclonal an...

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Vydáno v:Pediatric pulmonology Ročník 52; číslo 2; s. 190 - 197
Hlavní autoři: Nové‐Josserand, Raphaële, Grard, Soazic, Auzou, Lila, Reix, Philippe, Murris‐Espin, Marlène, Brémont, François, Mammar, Benyebka, Mely, Laurent, Hubert, Dominique, Durieu, Isabelle, Burgel, Pierre‐Régis
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Wiley Subscription Services, Inc 01.02.2017
Témata:
Adolescent
Adrenal Cortex Hormones - therapeutic use
Adult
allergic bronchopulmonary aspergillosis (ABPA)
Anti-Allergic Agents - therapeutic use
Antifungal Agents - therapeutic use
Aspergillosis, Allergic Bronchopulmonary - complications
Aspergillosis, Allergic Bronchopulmonary - drug therapy
Aspergillosis, Allergic Bronchopulmonary - immunology
Aspergillus fumigatus
Child
corticosteroids
cystic fibrosis
Cystic Fibrosis - complications
Drug Therapy, Combination
Female
Humans
IgE
immunoglobulin E
Immunoglobulin E - immunology
Male
Middle Aged
Omalizumab - therapeutic use
Retrospective Studies
Young Adult
corticosteroids
Aspergillus fumigatus
allergic bronchopulmonary aspergillosis (ABPA)
immunoglobulin E
IgE
cystic fibrosis
ISSN:8755-6863, 1099-0496, 1099-0496
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Shrnutí:Summary Allergic bronchopulmonary aspergillosis (ABPA) affects up to 15% of patients with cystic fibrosis (CF). Corticosteroids are used as first‐line therapy, but relapse and adverse effects commonly occur. Case reports have suggested the efficacy of the anti‐IgE recombinant humanized monoclonal antibody omalizumab. A retrospective multicenter observational French study retrieved 32 CF patients (11 children and 21 adults) who have received omalizumab for more than 3 months in the context of ABPA. Clinical characteristics, concomitant medications (inhaled and oral corticosteroids, antifungal drugs), lung function, body mass index (BMI), and serum IgE were compared at the start and during the first year of omalizumab therapy. Omalizumab‐related adverse effects and costs were also evaluated. No significant difference with omalizumab could be demonstrated with regard to lung function, BMI, or the number of patients receiving oral corticosteroids. At the time of initiation of omalizumab, 56% of patients were receiving oral corticosteroids. Five patients were able to discontinue corticosteroids during follow‐up and nine patients were able to reduce their daily dose. A total of 78% of the patients had received antifungal therapy at the time of the initiation of omalizumab. Treatment tolerance was good (12.5% of patients experienced side effects). The median cost of omalizumab treatment was €3,620 per patient per month. Omalizumab may represent a steroid‐sparing therapy in CF patients with ABPA. A randomized‐controlled trial is urgently required to provide higher level of evidence regarding the efficacy and cost‐effectiveness of omalizumab in CF patients with ABPA. Pediatr Pulmonol. 2017;52:190–197. © 2016 Wiley Periodicals, Inc.
Bibliografie:ObjectType-Article-1
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ISSN:8755-6863
1099-0496
1099-0496
DOI:10.1002/ppul.23612