280 Use of Omalizumab in Chronic Moderate to Severe Persistent Asthma-an Indian Experience

BACKGROUND: The worldwide prevalence of asthma is high and increasing. In India prevalence of asthma is variable from 4% to 20%. Despite ICS plus LABA therapy 72% of asthma patients were uncontrolled or not well controlled in INSPIRE study. Immunoglobulin-E plays a central role in inflammatory cascade. To study the efficacy of omalizumab in Indian patients with moderate to severe persistent asthma in terms of quality of life (QOL) improvement, reduction in severe exacerbation, ED visits and loss of working days. METHODS: 52 patients aged from 12+ years to 86 years (23.3 % females, avg age: 33.6, avg S.IgE: 283) fulfilling omalizumab indication criteria were given 150 mg subcutaneously once in 2 or 4 weeks for 16 to 24 weeks during March 2007 till date. QOL assessment 52 weeks after treatment in terms of following parameters were studied: Asthma symptoms (Cough, wheezing, tightness in the chest) Night Symptoms (frequent awakening, sleep disturbances) Rescue medication use Loss of working days/school days Emergency visits. RESULTS: 94% of patients were able to reduce or discontinue regular OCS use. 72% reduction in exacerbations, 76% reductions in emergency visits ICS/LABA dose was maintained/reduced in ∼ 93 % patients. –54% improvement in working/school days in the age group of 12 to 40 years. 60% improvement in uninterrupted sleep hours best improvement in QOL was observed in 12 to 40 years age group. CONCLUSIONS: Omalizumab is well tolerated and effective as an add-on therapy in patients of moderate to severe persistent Asthma and offers a therapeutic and economic benefit to patient. Its potential as disease modifier and early intervention in treatment guidelines needs further studies.