The 'real-life' long-term efficacy of omalizumab in severe persistent IgE-mediated allergic asthma in Malta

Abstract

Introduction: Omalizumab is a recombinant monoclonal anti-IgE antibody used in severe IgE-mediated asthma. Few studies include analysis of long-term efficacy beyond 1 year, and most patients do require long-term treatment. Aim: To analyse the long-term efficacy of omalizumab in adult patients following 1 and 3 years of treatment. Method: All adult patients who were started on omalizumab for severe persistent allergic asthma since 2012 were included. Patients were reviewed regularly and outcomes were analysed and compared 1 year before and 1 and 3 years post-initiation of treatment. Outcomes included Asthma Control Test(ACT) scores, FEV 1 , number of exacerbations, hospitalizations, unscheduled health-care visits and number of systemic corticosteroid courses required. Results: 18 patients were included in this study,66% males,mean age 5.2(±9.7) years. The mean IgE level was 413.4(±409) IU/ml. The mean ACT score improved at 1 year( p p p =0.05) and even further at 3 years ( p =0.004). The mean number of unscheduled healthcare visits decreased at 1 year( p =0.09) and at 3 years( p =0.05). The mean number of systemic corticosteroid courses required decreased at 1 year( p =0.02) and at 3 years( p =0.01). There was no significant decline in hospitalisation rate or significant improvement in FEV 1 . Conclusion: Omalizumab in severe asthmatic patients leads to improved ACT scores, decreased exacerbations, unscheduled health-care visits and oral corticosteroid courses. These benefits were noted after 1 year and maintained 3 years later. Further evaluation of our cohort will assess treatment efficacy in the longer term.