Omalizumab in allergic bronchopulmonary aspergillosis in patients with cystic fibrosis.

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Omalizumab in allergic bronchopulmonary aspergillosis in patients with cystic fibrosis.

J Asthma Allergy. 2018;11:101-107

Authors: Ashkenazi M, Sity S, Sarouk I, Bar Aluma BE, Dagan A, Bezalel Y, Bentur L, De Boeck K, Efrati O

Abstract
Background: Allergic bronchopulmonary aspergillosis (ABPA) is a condition characterized by a Th2 response, serum eosinophilia, and increased total serum IgE to Aspergillus fumigatus. ABPA occurs in cystic fibrosis (CF) and asthma. Omalizumab is a humanized recombinant monoclonal antibody against IgE. Previous studies reported borderline results when treating ABPA with omalizumab.
Methods: A retrospective study to investigate the efficacy of omalizumab in the treatment of ABPA in CF patients was conducted at 3 CF centers in Israel and Belgium. Data were obtained from the digital archive. We measured 4 outcome parameters: forced expiratory volume in 1 second, body mass index, pulmonary exacerbations, and steroid sparing.
Results: The database was composed on the records of 9 patients. None of the outcome parameters showed any improvement. A favorable outcome was observed in patients with higher levels of posttreatment total IgE than those with lower levels. CF-related diabetes and male gender showed trends for poorer outcomes.
Conclusion: No benefits were detected on treating ABPA in CF with omlaizumb. Monitoring the total IgE was not helpful. A prospective randomized double-blind study is needed.

PMID: 29950869 [PubMed]

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