Omalizumab is effective in allergic and nonallergic patients with nasal polyps
and asthma.
Author(s): Gevaert P(1), Calus L, Van Zele T, Blomme K, De Ruyck N, Bauters W, Hellings P,
Brusselle G, De Bacquer D, van Cauwenberge P, Bachert C.
Affiliation(s): Author information:
(1)Upper Airways Research Laboratory, Department of Otorhinolaryngology, Ghent
University Hospital, Ghent, Belgium. philippe.gevaert@UGent.be
Publication date & source: 2013, J Allergy Clin Immunol. , 131(1):110-6
BACKGROUND: Adult patients with nasal polyps often have comorbid asthma, adding
to the serious effect on the quality of life of these patients. Nasal polyps and
asthma might represent a therapeutic challenge; inflammation in both diseases
shares many features, such as airway eosinophilia, local IgE formation, and a
T(H)2 cytokine profile. Omalizumab is a human anti-IgE mAb with proved efficacy
in patients with severe allergic asthma. Omalizumab could be a treatment option
for patients with nasal polyps and asthma.
OBJECTIVE: The goal of this study was to investigate the clinical efficacy of
omalizumab in patients with nasal polyps and comorbid asthma.
METHODS: A randomized, double-blind, placebo-controlled study of allergic and
nonallergic patients with nasal polyps and comorbid asthma (n = 24) was
conducted. Subjects received 4 to 8 (subcutaneous) doses of omalizumab (n = 16)
or placebo (n = 8). The primary end point was reduction in total nasal endoscopic
polyp scores after 16 weeks. Secondary end points included a change in sinus
computed tomographic scans, nasal and asthma symptoms, results of validated
questionnaires (Short-Form Health Questionnaire, 31-item Rhinosinusitis Outcome
Measuring Instrument, and Asthma Quality of Life Questionnaire), and serum/nasal
secretion biomarker levels.
RESULTS: There was a significant decrease in total nasal endoscopic polyp scores
after 16 weeks in the omalizumab-treated group (-2.67, P = .001), which was
confirmed by means of computed tomographic scanning (Lund-Mackay score).
Omalizumab had a beneficial effect on airway symptoms (nasal congestion, anterior
rhinorrhea, loss of sense of smell, wheezing, and dyspnea) and on quality-of-life
scores, irrespective of the presence of allergy.
CONCLUSION: Omalizumab demonstrated clinical efficacy in the treatment of nasal
polyps with comorbid asthma, supporting the importance and functionality of local
IgE formation in the airways.
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