Beneficial effects of Omalizumab therapy in allergic bronchopulmonary aspergillosis: A synthesis review of published literature

Abstract

Omalizumab, a humanized mAb that binds to IgE, has been an effective therapy for patients with severe allergic asthma; however, there are few clinical trials examining the efficacy of Omalizumab in patients with allergic bronchopulmonary aspergillosis (ABPA) except some case reports. To assess the clinical and immunological effects of Omalizumab in ABPA patients, we made a synthesis review of 102 cases from 30 published literature, analyzed the effects of Omalizumab therapy in ABPA and conducted subgroup analyses to determine factors that influenced the therapy endpoints. We found that Omalizumab treatment not only provided a clinically important reduction in serum IgE, exacerbation rates and steroid requirement, but also showed attenuated asthma symptoms and improved pulmonary function parameters in patients with ABPA. Moreover, further discussion was made when interpretating the results. Double-blind, randomized, placebo-controlled trials are necessary to establish the efficacy and safety of this novel therapeutic intervention for ABPA patients.

Aspergillosis

“…Recently in China, Li JX et al found that Omalizumab treatment is effective not only in decreasing IgE levels but also causes reduction in steroid requirement and improves pulmonary functions. 13 In present case, we could not use omalizumab due to its limited availability and financial recourses and only a combination of steroids and itraconazole provided excellent results.…”

65-Year-Old Woman With a Wheeze

“…9 A review of 102 published cases of ABPA treated with omalizumab concluded that the drug helped mitigate symptoms, improve PFTs, and decrease corticosteroid requirements. 10 With the increasing use of omalizumab in refractory ABPA, there is interest in developing monoclonal antibodies that target other portions of ABPA's inflammatory cascade. Antieinterleukin 5 therapy (mepolizumab) has shown promising anecdotal results, demonstrating better symptom control, particularly when used in conjunction with omalizumab.…”

An ABPA Case With an Initial Diagnosis and Treatment of Smear Negative Pulmonary Tuberculosis

“…In the treatment of asthma, omalizumab dose is adjusted according to serum IgE levels, whereas it is difficult to regulate its dose because of already higher serum IgE levels in ABPA. Based on clinical experience, and a limited number of studies, subcutaneous 375 mg omalizumab twice a month is another alternative treatment option in ABPA cases [18][19][20][21] .…”