Omalizumab is equally effective in persistent allergic oral corticosteroid-dependent asthma whether due to seasonal allergens or to perennial allergens

Abstract

Background: Omalizumab (OMA) is marketed for severe asthma patients allergic to perennial allergens. Our purpose was to investigate whether OMA is also as effective in severe asthma due to seasonal allergens. Method: Population: 30 patients with oral corticosteroid-dependent asthma (receiving 4 mg of methyl-prednisolone (MP) per day ≥ 1 year or boosters of MP equivalent to a mean daily dose of 4 mg of MP). For each patient with asthma due to seasonal allergens, we recruited the next two consecutive patients with asthma due to perennial allergens. Protocol: a) OMA dose was calculated according to the dosing table; b) patients were considered responders or non-responders after six months of treatment with OMA; c) the dose of oral MP was tapered at a rate of 2 mg every two weeks depending on tolerance; f) at every monthly visit, forced spirometry (S) was performed and the accumulated monthly MP dose was calculated. Results: At entry there were no differences in gender, body mass index or obesity, monthly dose of MP or S between groups (Perennial: FVC: 76% (20); FEV1: 62% (22); Seasonal: FVC: 79% (12); FEV1:70% (16)). Follow-up: One patient in each group was considered a non-responder; S did not deteriorate in either group. There was a significant intragroup decrease in MP consumption (p<0.001) but no differences were detected in the intergroup comparison (P=0.958). Conclusions: 1) In these cohorts of patients, OMA seemed to offer the same clinical benefits independently of whether the asthma was caused by a seasonal or perennial allergen; 2) The patient's drop-out rate (10-20%) was expected in the light of previous literature reports.