Evaluation of the clinical features and laboratory data of patients with severe asthma classified as super-responder or non super-responder to omalizumab treatment: a single-center real-life study.

INTRODUCTION

Omalizumab is used for the treatment of severe allergic asthma.

OBJECTIVE

The aim of this study was to evaluate the clinical features and laboratory data of patients with severe allergic asthma classified as super-responder or non super-responder to omalizumab.

METHODS

Comparisons were made of the laboratory data and clinical features of patients with severe allergic asthma. Patients who had no asthma exacerbation, no oral corticosteroid (OCS) use, asthma control test (ACT) score >20 and forced expiratory volume in 1 s (FEV1) >80% were considered super-responder after omalizumab.

RESULTS

A total of 90 patients were included in the study, comprising 19 (21.1%) males. The age at onset of asthma, allergic rhinitis rate, number of endoscopic sinus surgeries (ESS), intranasal corticosteroid (INS) use, baseline FEV 1 (%) and ACT score were significantly higher in the omalizumab super-responder group ( = 0.013,  = 0.015,  = 0.002,  = 0.001,  = 0.001 and  < 0.001, respectively). The duration of asthma, rate of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP), regular use of OCS, baseline eosinophil count and eosinophil-to-lymphocyte ratio were significantly higher in the omalizumab non super-responder group ( = 0.015,  < 0.001,  = 0.004,  < 0.001 and  < 0.001, respectively). Blood eosinophil count (AUC: 0.187,  < 0.001), eosinophil-to-lymphocyte ratio (AUC: 0.150,  < 0.001) and FEV1 (%) (AUC:0.779,  = 0.001) were determined to have diagnostic value in predicting the treatment response to omalizumab of patients with severe allergic asthma.

CONCLUSION

High-blood eosinophil levels, CRSwNP and low pretreatment lung capacity may affect omalizumab treatment response in patients with severe allergic asthma. These results should be supported by further multicenter real-life studies.