Omalizumab in allergic bronchopulmonary aspergillosis in patients with cystic fibrosis

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.

Keywords:

• ABPA
• Omalizumab
• CF
• IgE

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Omalizumab in allergic bronchopulmonary aspergillosis in patients with cystic fibrosis [Erratum]

Author contributions

MA participated in study design, data collection, statistical analysis, data interpretation, and writing the paper, and is a guarantor of the paper. SS was involved in data collection. IS, BB, AD, and YB played a role in study design and data interpretation. LB helped with the data collection, data interpretation, and paper revision. KDB played a role in data collection, data interpretation, and paper revision. OE assisted with the study design, data interpretation, and paper revision. All authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.