Cargando…

Omalizumab in the treatment of eosinophilic granulomatosis with polyangiitis (EGPA): single-center experience in 18 cases

BACKGROUND: Data are limited regarding the effectiveness of omalizumab in patients with eosinophilic granulomatosis with polyangiitis (EGPA). Our aim was to evaluate the clinical and functional effectiveness of omalizumab in patients with EGPA in long-term follow-up. METHODS: This study was a retros...

Descripción completa

Detalles Bibliográficos
Autores principales: Celebi Sozener, Zeynep, Gorgulu, Begum, Mungan, Dilsad, Sin, Betul Ayse, Misirligil, Zeynep, Aydin, Omur, Bavbek, Sevim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276141/
https://www.ncbi.nlm.nih.gov/pubmed/30524647
http://dx.doi.org/10.1186/s40413-018-0217-0
_version_ 1783377952885440512
author Celebi Sozener, Zeynep
Gorgulu, Begum
Mungan, Dilsad
Sin, Betul Ayse
Misirligil, Zeynep
Aydin, Omur
Bavbek, Sevim
author_facet Celebi Sozener, Zeynep
Gorgulu, Begum
Mungan, Dilsad
Sin, Betul Ayse
Misirligil, Zeynep
Aydin, Omur
Bavbek, Sevim
author_sort Celebi Sozener, Zeynep
collection PubMed
description BACKGROUND: Data are limited regarding the effectiveness of omalizumab in patients with eosinophilic granulomatosis with polyangiitis (EGPA). Our aim was to evaluate the clinical and functional effectiveness of omalizumab in patients with EGPA in long-term follow-up. METHODS: This study was a retrospective chart review of patients with EGPA who were treated with omalizumab injections between May 2012 and April 2018. Once treatment with omalizumab was started, data were collected at various time points: baseline, the 16th week, 1st year, and annually until the last evaluation. RESULTS: Eighteen patients (16F/2M) with a mean age of 48.61 ± 11.94 years were included. Data were available for all patients for the first year, 12 patients for the second year, 10 patients for the third  year, 8 patients for the fourth  year and 5 patients for the fifth year. All patients were on mean dosage of 15.77 ± 7.6 mg/day oral corticosteroid (OCS) as daily bases for mean 8.61 ± 4 years besides high-dose inhaler corticosteroid/long-acting beta agonist. Antineutrophil cytoplasmic antibodies (ANCA) were positive in 2  patients, and 8 patients were diagnosed as having vasculitis by skin biopsy, one patient had polyneuropathy, and one patient had cardiac involvement. By considering the individual responses of patients and the level of improvement at the last evalulation, 10 (55.6%) patients responded completely, 1 responded partially, and 7 (38.9%) had no improvement. Omalizumab worked as a steroid-sparing agent in all patients and the daily OCS dose was reduced with a mean dosage of 6.28 mg/day at the end of the first year. The mean OCS reduction time for the whole group was 4 months. A reduction in asthma exacerbations/hospitalizations, improvement in forced expiratory volume in 1 second, and no decrease in the eosinophil count during treatment with omalizumab were also observed. CONCLUSIONS: Omalizumab improved asthma control in some patients with EGPA with uncontrolled asthma by reducing asthma exacerbations and oral steroid requirement. However, more data are needed before recommending widespread use of omalizumab in patients with EGPA.
format Online
Article
Text
id pubmed-6276141
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-62761412018-12-06 Omalizumab in the treatment of eosinophilic granulomatosis with polyangiitis (EGPA): single-center experience in 18 cases Celebi Sozener, Zeynep Gorgulu, Begum Mungan, Dilsad Sin, Betul Ayse Misirligil, Zeynep Aydin, Omur Bavbek, Sevim World Allergy Organ J Original Research BACKGROUND: Data are limited regarding the effectiveness of omalizumab in patients with eosinophilic granulomatosis with polyangiitis (EGPA). Our aim was to evaluate the clinical and functional effectiveness of omalizumab in patients with EGPA in long-term follow-up. METHODS: This study was a retrospective chart review of patients with EGPA who were treated with omalizumab injections between May 2012 and April 2018. Once treatment with omalizumab was started, data were collected at various time points: baseline, the 16th week, 1st year, and annually until the last evaluation. RESULTS: Eighteen patients (16F/2M) with a mean age of 48.61 ± 11.94 years were included. Data were available for all patients for the first year, 12 patients for the second year, 10 patients for the third  year, 8 patients for the fourth  year and 5 patients for the fifth year. All patients were on mean dosage of 15.77 ± 7.6 mg/day oral corticosteroid (OCS) as daily bases for mean 8.61 ± 4 years besides high-dose inhaler corticosteroid/long-acting beta agonist. Antineutrophil cytoplasmic antibodies (ANCA) were positive in 2  patients, and 8 patients were diagnosed as having vasculitis by skin biopsy, one patient had polyneuropathy, and one patient had cardiac involvement. By considering the individual responses of patients and the level of improvement at the last evalulation, 10 (55.6%) patients responded completely, 1 responded partially, and 7 (38.9%) had no improvement. Omalizumab worked as a steroid-sparing agent in all patients and the daily OCS dose was reduced with a mean dosage of 6.28 mg/day at the end of the first year. The mean OCS reduction time for the whole group was 4 months. A reduction in asthma exacerbations/hospitalizations, improvement in forced expiratory volume in 1 second, and no decrease in the eosinophil count during treatment with omalizumab were also observed. CONCLUSIONS: Omalizumab improved asthma control in some patients with EGPA with uncontrolled asthma by reducing asthma exacerbations and oral steroid requirement. However, more data are needed before recommending widespread use of omalizumab in patients with EGPA. BioMed Central 2018-12-03 /pmc/articles/PMC6276141/ /pubmed/30524647 http://dx.doi.org/10.1186/s40413-018-0217-0 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research
Celebi Sozener, Zeynep
Gorgulu, Begum
Mungan, Dilsad
Sin, Betul Ayse
Misirligil, Zeynep
Aydin, Omur
Bavbek, Sevim
Omalizumab in the treatment of eosinophilic granulomatosis with polyangiitis (EGPA): single-center experience in 18 cases
title Omalizumab in the treatment of eosinophilic granulomatosis with polyangiitis (EGPA): single-center experience in 18 cases
title_full Omalizumab in the treatment of eosinophilic granulomatosis with polyangiitis (EGPA): single-center experience in 18 cases
title_fullStr Omalizumab in the treatment of eosinophilic granulomatosis with polyangiitis (EGPA): single-center experience in 18 cases
title_full_unstemmed Omalizumab in the treatment of eosinophilic granulomatosis with polyangiitis (EGPA): single-center experience in 18 cases
title_short Omalizumab in the treatment of eosinophilic granulomatosis with polyangiitis (EGPA): single-center experience in 18 cases
title_sort omalizumab in the treatment of eosinophilic granulomatosis with polyangiitis (egpa): single-center experience in 18 cases
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276141/
https://www.ncbi.nlm.nih.gov/pubmed/30524647
http://dx.doi.org/10.1186/s40413-018-0217-0
work_keys_str_mv AT celebisozenerzeynep omalizumabinthetreatmentofeosinophilicgranulomatosiswithpolyangiitisegpasinglecenterexperiencein18cases
AT gorgulubegum omalizumabinthetreatmentofeosinophilicgranulomatosiswithpolyangiitisegpasinglecenterexperiencein18cases
AT mungandilsad omalizumabinthetreatmentofeosinophilicgranulomatosiswithpolyangiitisegpasinglecenterexperiencein18cases
AT sinbetulayse omalizumabinthetreatmentofeosinophilicgranulomatosiswithpolyangiitisegpasinglecenterexperiencein18cases
AT misirligilzeynep omalizumabinthetreatmentofeosinophilicgranulomatosiswithpolyangiitisegpasinglecenterexperiencein18cases
AT aydinomur omalizumabinthetreatmentofeosinophilicgranulomatosiswithpolyangiitisegpasinglecenterexperiencein18cases
AT bavbeksevim omalizumabinthetreatmentofeosinophilicgranulomatosiswithpolyangiitisegpasinglecenterexperiencein18cases