Omalizumab: a new treatment option for allergic bronchopulmonary aspergillosis in patients with cystic fibrosis

Lehmann, Sylvia; Pfannenstiel, Claus; Friedrichs, Frank; Kröger, Kristina; Wagner, Norbert; Tenbrock, Klaus

doi:10.1177/1753465814547517

Cited by 35 publications

(34 citation statements)

References 24 publications

(51 reference statements)

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“…Omalizumab has also demonstrated its clinical relevance in patients with allergic bronchopulmonary aspergillosis (ABPA), an allergic reaction to Aspergillus characterized by high IgE levels, which usually occurs in combination with cystic fibrosis (CF) [86, 87]. Several case series have also reported success with OmAb in ABPA patients without CF [88, 89].…”

Section: Anti-ige-based Treatmentsmentioning

confidence: 99%

IgE-Related Chronic Diseases and Anti-IgE-Based Treatments

Navinés-Ferrer

Serrano‐Candelas

Molina-Molina

et al. 2016

Journal of Immunology Research

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IgE is an immunoglobulin that plays a central role in acute allergic reactions and chronic inflammatory allergic diseases. The development of a drug able to neutralize this antibody represents a breakthrough in the treatment of inflammatory pathologies with a probable allergic basis. This review focuses on IgE-related chronic diseases, such as allergic asthma and chronic urticaria (CU), and on the role of the anti-IgE monoclonal antibody, omalizumab, in their treatment. We also assess the off-label use of omalizumab for other pathologies associated with IgE and report the latest findings concerning this drug and other new related drugs. To date, omalizumab has only been approved for severe allergic asthma and unresponsive chronic urticaria treatments. In allergic asthma, omalizumab has demonstrated its efficacy in reducing the dose of inhaled corticosteroids required by patients, decreasing the number of asthma exacerbations, and limiting the effect on airway remodeling. In CU, omalizumab treatment rapidly improves symptoms and in some cases achieves complete disease remission. In systemic mastocytosis, omalizumab also improves symptoms and its prophylactic use to prevent anaphylactic reactions has also been discussed. In other pathologies such as atopic dermatitis, food allergy, allergic rhinitis, nasal polyposis, and keratoconjunctivitis, omalizumab significantly improves clinical manifestations. Omalizumab acts in two ways: by sequestering free IgE and by accelerating the dissociation of the IgE-Fcε receptor I complex.

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Section: Anti-ige-based Treatmentsmentioning

confidence: 99%

IgE-Related Chronic Diseases and Anti-IgE-Based Treatments

Navinés-Ferrer

Serrano‐Candelas

Molina-Molina

et al. 2016

Journal of Immunology Research

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“…However, the ideal treatment duration of Omalizumab for ABPA is still ambiguous; Richard B. Moss (2012) reported a case of Omalizumab use as long as 5 years wherein an attempt to discontinue Omalizumab in late 2010 resulted in an exacerbation, decline in lung function, and rise in IgE levels, which were resolved with reinstitution of Omalizumab [39]. Sylvia L.et al (2014) also reported two subjects that experienced exacerbation after Omalizumab withdrawal [46].…”

Section: Discussionmentioning

confidence: 99%

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

Fan

et al. 2017

Respiratory Medicine

102

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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.

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“…However, the experience cases reported lacked a comparison, placebotreated group. Lehmann et al published their experience with omalizumab in six patients with CF and ABPA, and all patients showed an improvement, but omalizumab therapy was less effective in patients with progressed lung disease and long-term ABPA [27]. Finally, Jat et al published a Cochrane review about anti-IgE therapy for ABPA in CF patients and authors concluded that there is lack of evidence for the efficacy of omalizumab therapy in patients with CF and ABPA [28].…”

Section: Allergic Bronchopulmonary Aspergillosismentioning

confidence: 92%

Off-Label Uses of Omalizumab

El-Qutob¹

2015

Clinic Rev Allerg Immunol

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The off-label use of medicines is a common and extensive clinical practice. Omalizumab has been licensed for use in severe allergic asthma and chronic urticaria. Omalizumab dosing was based on body weight and baseline serum IgE concentration. All patients are required to have a baseline IgE between 30 and 700 IU/ml and body weight not more than 150 kg. The use of off-label drugs may lead to several problems including adverse effects and an increased risk/benefit balance. In this article, there are summarized off-label uses of omalizumab in the last recent years in diseases in which IgE maybe or certainly has a corner role such as allergic rhinitis, allergic bronchopulmonary aspergillosis, anaphylaxis, keratoconjunctivitis, food allergy, drug allergy, urticaria, angioedema, non-atopic asthma, atopic dermatitis, nasal polyps, Churg-Strauss syndrome, eosinophilic otitis media, chronic rhinosinusitis, bullous pemphigoid, contact dermatitis, and others. Use in pregnancy asthmatic women and pre-co-administration with specific immunotherapy will also be revised.

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Omalizumab: a new treatment option for allergic bronchopulmonary aspergillosis in patients with cystic fibrosis

Abstract: Background: Allergic bronchopulmonary aspergillosis

Cited by 35 publications

References 24 publications

IgE-Related Chronic Diseases and Anti-IgE-Based Treatments

IgE-Related Chronic Diseases and Anti-IgE-Based Treatments

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

Off-Label Uses of Omalizumab

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