Scioscia Giulia, Buonamico Enrico, Foschino Barbaro Maria Pia, Lacedonia Donato, Sabato Roberto, Carpagnano Giovanna Elisiana
Institute of Respiratory Diseases, Department of Medical and Surgical Sciences University of Foggia Foggia Italy.
Institute of Respiratory Diseases, Department of Neurosciences University of Bari Bari Italy.
Respirol Case Rep. 2020 Feb 7;8(2):e0518. doi: 10.1002/rcr2.518. eCollection 2020 Mar.
Obstructive sleep apnoea (OSA) syndrome, the most frequent sleep-disordered breathing, is a comorbidity of asthma, whose prevalence covers about 49.5% of asthmatic adult patients. A 61-year-old female patient, affected by severe allergic asthma and obesity, started treatment with omalizumab and underwent polysomnography showing a severe OSA pattern (apnoea/hypopnoea index (AHI): 72.7). After six months, she showed functional improvement and good asthma symptoms control and underwent a new polygraphy for the persistence of the night symptoms which showed an ameliorated, despite still severe, OSA pattern (AHI: 31.9). The patient obtained complete polygraphic normalization after adequate positive airway pressure (PAP) titration. While bronchodilator efficacy in chronic obstructive pulmonary disease (COPD)/OSA overlap syndrome has been proven in raising nocturnal oxygen saturation, there is no such evidence about biological therapy in patients affected by severe asthma and OSA. This is the first documented case report that demonstrates a possible role of omalizumab in improving the OSA pattern in a patient affected by severe asthma and OSA.
阻塞性睡眠呼吸暂停（OSA）综合征是最常见的睡眠呼吸障碍，是哮喘的一种合并症，其患病率约占成年哮喘患者的49.5%。一名61岁的女性患者，患有严重的过敏性哮喘和肥胖症，开始使用奥马珠单抗治疗，并接受了多导睡眠图检查，结果显示为严重的OSA模式（呼吸暂停/低通气指数（AHI）：72.7）。六个月后，她的功能有所改善，哮喘症状得到了良好控制，并且由于夜间症状持续存在而再次接受多导睡眠图检查，结果显示OSA模式有所改善（尽管仍然严重）（AHI：31.9）。在进行了适当的气道正压通气（PAP）滴定后，该患者的多导睡眠图完全恢复正常。虽然支气管扩张剂在慢性阻塞性肺疾病（COPD）/OSA重叠综合征中提高夜间氧饱和度的疗效已得到证实，但对于重度哮喘和OSA患者的生物治疗尚无此类证据。这是第一份有记录的病例报告，证明了奥马珠单抗在改善重度哮喘和OSA患者的OSA模式方面可能发挥的作用。
