Efficacy of omalizumab treatment in a man with occupational asthma and eosinophilic granulomatosis with polyangioitis

Gencarelli, Giorgia; Gaeta, Francesco; Valluzzi, Rocco Luigi; Rumi, Gabriele; Romano, Antonino

doi:10.1016/j.anai.2017.10.034

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Several studies with omalizumab have been published over the years with promising and beneficial results in the treatment of eosinophilic allergic asthma and it is therefore believed that it may also be considered an effective therapy in the treatment of patients with EGPA, particularly in those patients with uncontrolled asthma symptoms. Unfortunately, experience with omalizumab in the treatment of EGPA is limited to single case reports [66][67][68][69][70] or case series only [12]. Most of these cases describe an improvement in asthma symptoms, nasal polyposis, and reduction in blood eosinophil counts [66,67,69,70].…”

Section: Omalizumabmentioning

confidence: 99%

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New therapeutic approaches with biological drugs for eosinophilic granulomatosis with polyangiitis

Carrón-Herrero

Pelaia

Paoletti

2023

Explor Asthma Allergy

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Eosinophilic granulomatosis with polyangiitis (EGPA) is a multiorganic syndrome that affects the cardiovascular, neurologic, renal, and gastrointestinal systems with an incidence ranging from 0 case to 67 cases per one million person-years, and its pathophysiology remains unknown. It is believed that genetic factors, the environment, and changes in immune system function contribute to the development of EGPA, overlapping the immune mechanisms of vasculitides and the pathologic mechanisms in eosinophilic syndromes. This disease is commonly divided into two phenotypes depending on the presence of antineutrophil cytoplasmic antibodies (ANCA). ANCA-positive patients usually have more vasculitic manifestations like peripheral neuropathy, purpura, renal involvement, and biopsy-proven vasculitis. The keystone of EGPA therapy is systemic corticosteroids (CS) as monotherapy or in combination with other immunosuppressive treatments, and recently the efficacy of eosinophil-targeted biotherapy, anti-interleukin-5 (IL-5), has been shown to be efficacious in EGPA. Although this phenotype/phase distinction has not yet had an impact on the current treatment strategies, emerging targeted biotherapies under evaluation could lead to a phenotype-based approach and personalised treatment regimens for EGPA patients. The present review describes the new therapeutical approaches with biological drugs for EGPA.

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Section: Omalizumabmentioning

confidence: 99%

“…Unfortunately, experience with omalizumab in the treatment of EGPA is limited to single case reports [66][67][68][69][70] or case series only [12]. Most of these cases describe an improvement in asthma symptoms, nasal polyposis, and reduction in blood eosinophil counts [66,67,69,70].…”

Section: Omalizumabmentioning

confidence: 99%

New therapeutic approaches with biological drugs for eosinophilic granulomatosis with polyangiitis

Carrón-Herrero

Pelaia

Paoletti

2023

Explor Asthma Allergy

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“…Another interesting drug is omalizumab, an anti-human immunoglobulin E murine mAb, which was demonstrated to be effective against allergic asthma, refractory chronic rhinosinusitis with nasal polyps, and refractory chronic spontaneous urticaria [106][107][108] . Some authors reported a favorable experience with omalizumab as steroid sparing agent in EGPA with persistent asthma and ENT manifestations, but half of the patients suffered asthma exacerbations [109][110][111][112] .…”

Section: Systemic Treatmentmentioning

confidence: 99%

Ear, nose, and throat in ANCA-associated vasculitis: a comprehensive review

Padoan¹,

Campaniello²,

Felicetti³

et al. 2021

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Ear, nose, and throat (ENT) involvement is a common feature in antineutrophil cytoplasmic antibody (ANCA)associated vasculitis (AAV), particularly in granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis. Over the last decade, substantial advancement has been made in understanding AAV pathogenesis, classification, and treatment. Typical ENT symptoms may include sinonasal, otologic, pharyngeal, and laryngeal manifestations. The otolaryngologic symptoms of AAV sometimes might be misdiagnosed in etiology as infectious or allergic. Thus, rapid recognition and early diagnosis of AAV as the cause of the symptoms prevent the risk of irreversible organ damage. The high impact of ENT symptoms on the quality of life of AAV patients confirms the importance of their early treatment through specific local and systemic approaches. Appropriate interdisciplinary management to early recognition of AAV and initiation of treatment may reduce morbidity in these patients. The purpose of this comprehensive review is to describe the clinical, histological, and radiological findings of ENT involvement in AAV and to update their surgical and therapeutic management, with a focus also on the role of a multidisciplinary team, involving the otorhinolaryngologist.

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“…Although venom immunotherapy is effective for bee-keepers with anaphylaxis to bee venom, there have been relatively few studies to provide any support for specific immunotherapy for occupational allergens. Use of a biological agent such as omalizumab has been reported only in small numbers of patients with occupational asthma,5556 so that further studies are needed to determine whether these will prevent responses to workplace sensitizers in those with occupational asthma and whether cost/benefit estimates should be considered.…”

Section: Managementmentioning

confidence: 99%

Update on the Management of Occupational Asthma and Work-Exacerbated Asthma

Lau

Tarlo

2019

Allergy Asthma Immunol Res

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Work-related asthma is the most common occupational lung disease encountered in clinical practice. In adult asthmatics, work-relatedness can account for 15%–33% of cases, but delays in diagnosis remain common and lead to worse outcomes. Accurate diagnosis of asthma is the first step to managing occupational asthma, which can be sensitizer-induced or irritant-induced asthma. While latency has traditionally been recognized as a hallmark of sensitizer-induced asthma and rapid-onset a defining feature of irritant-induced asthma (as in Reactive Airway Dysfunction Syndrome), there is epidemiological evidence for irritant-induced asthma with latency from chronic moderate exposure. Diagnostic testing while the patient is still in the workplace significantly improves sensitivity. While specific inhalational challenges remain the gold-standard for the diagnosis of occupational asthma, they are not available outside of specialized centers. Commonly available tests including bronchoprovocation challenges and peak flow monitoring are important tools for practicing clinicians. Management of sensitizer-induced occupational asthma is notable for the central importance of removal from the causative agent: ideally, removal of the culprit agent; but if not feasible, this may require changes in the work process or ultimately, removal of the worker from the workplace. While workers' compensation programs may reduce income loss, these are not universal and there can be significant socio-economic impact from work-related asthma. Primary prevention remains the preferred method of reducing the burden of occupational asthma, which may include modification to work processes, better worker education and substitution of sensitizing agents from the workplace with safer compounds.

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Efficacy of omalizumab treatment in a man with occupational asthma and eosinophilic granulomatosis with polyangioitis

Cited by 4 publications

References 8 publications

New therapeutic approaches with biological drugs for eosinophilic granulomatosis with polyangiitis

New therapeutic approaches with biological drugs for eosinophilic granulomatosis with polyangiitis

Ear, nose, and throat in ANCA-associated vasculitis: a comprehensive review

Update on the Management of Occupational Asthma and Work-Exacerbated Asthma

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