Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, 310003, People's Republic of China.
BMC Pulm Med. 2023 Oct 13;23(1):389. doi: 10.1186/s12890-023-02696-x.
Omalizumab is a valuable alternative treatment for allergic bronchopulmonary aspergillosis (ABPA). The effectiveness and safety of this medication have not been confirmed. The main purpose of this study was to evaluate the effectiveness and safety of omalizumab for ABPA.
This study involved a retrospective chart review. The main indicators used were asthma control test (ACT) scores, lung function parameters, doses of corticosteroids, acute exacerbation, hospitalization rates, total serum immunoglobulin E (IgE) levels, and blood eosinophil counts. Related adverse events were also reviewed to evaluate the safety of omalizumab.
Fourteen patients with ABPA were included, of whom 10 (71%) concurrently had allergic rhinitis (AR). There were improvements in the mean percentages of the forced vital capacity, percentages of the forced expiratory volume in 1 s, and ACT score after omalizumab administration (p < 0.05, p < 0.01, and p < 0.01, respectively). After the initiation of omalizumab administration, the median corticosteroid dose, acute exacerbation rate, hospitalization rate, and mean blood eosinophil count decreased when compared with the baseline values (p < 0.05, p < 0.05, p < 0.01, and p < 0.05, respectively). A reduction in the total serum IgE level was observed in patients with ABPA without AR compared with that in patients with AR (p < 0.05). One patient reported a concurrent skin rash, which spontaneously resolved without medication.
It is safe and effective to prescribe omalizumab to patients with ABPA, irrespective of whether they have AR. Dose adjustment of omalizumab is safe after disease control. The total serum IgE level might be a predictor of the effectiveness of omalizumab in patients without AR.
奥马珠单抗是一种治疗变应性支气管肺曲霉病（ABPA）的有效替代药物。该药的疗效和安全性尚未得到证实。本研究的主要目的是评估奥马珠单抗治疗 ABPA 的疗效和安全性。
这是一项回顾性图表研究。主要指标包括哮喘控制测试（ACT）评分、肺功能参数、皮质类固醇剂量、急性加重、住院率、总血清免疫球蛋白 E（IgE）水平和血嗜酸性粒细胞计数。还回顾了相关不良反应，以评估奥马珠单抗的安全性。
共纳入 14 例 ABPA 患者，其中 10 例（71%）同时患有变应性鼻炎（AR）。奥马珠单抗治疗后，用力肺活量的平均百分比、1 秒用力呼气量的百分比和 ACT 评分均有改善（p<0.05、p<0.01 和 p<0.01）。奥马珠单抗治疗开始后，与基线值相比，皮质类固醇剂量中位数、急性加重率、住院率和平均血嗜酸性粒细胞计数均降低（p<0.05、p<0.05、p<0.01 和 p<0.05）。与 AR 患者相比，无 AR 的 ABPA 患者的总血清 IgE 水平降低（p<0.05）。1 例患者报告出现皮疹，无需药物治疗即可自行缓解。
奥马珠单抗治疗 ABPA 安全有效，无论患者是否患有 AR。疾病控制后，奥马珠单抗的剂量调整是安全的。总血清 IgE 水平可能是预测无 AR 患者奥马珠单抗疗效的指标。
