[Quality of life in patients with allergic asthma on treatment with omalizumab]

Rev Alerg Mex. 2018 Oct-Dec;65(4):349-356. doi: 10.29262/ram.v65i4.382.
[Article in Spanish]

Abstract

Background: Omalizumab is a monoclonal antibody that controls severe allergic asthma symptoms and reduces exacerbations.

Objective: To analyze quality of life and respiratory function improvement using the mini-AQLQ questionnaire and spirometry, with the use omalizumab as complementary therapy to a treatment with inhaled corticosteroids and long-acting beta 2 agonists.

Methods: Of 30 patients with severe asthma (90 % of females, mean age, 49.1 years) the evolution of severe asthma diagnosis ranged from 1 to 24 years (average 8.3 years). All of them had at least one cutaneous or IgE-specific test that was positive to a usual aeroallergen, had total IgE determined and underwent spirometry. The mini-AQLQ questionnaire was applied and forced expiratory volume in 1 second (FEV1) was determined at baseline and at 52 weeks of omalizumab administration, the average dose of which was 550 mg, with biweekly or monthly administration.

Results: There was statistically significant improvement (p = 0.013) in the mini-AQLQ after 52 weeks, with an overall score of 4.5, mainly in the emotional (p = 0.0073) and environmental dimensions (p = 0.00014). There were no significant changes in FEV1. Obesity was observed in 63 % of patients, and overweight in 26 %.

Conclusions: Omalizumab improved patient quality of life, with no significant changes in FEV1, probably due to obesity.

Antecedentes: El omalizumab es un anticuerpo monoclonal que controla los síntomas y reduce las exacerbaciones del asma alérgica grave. Objetivo: Analizar mediante el cuestionario mini-AQLQ y espirometría, la mejoría en la calidad de vida y función respiratoria con el omalizumab como complemento del tratamiento con corticosteroides inhalados y agonista beta-2 de acción prolongada. Métodos: De 30 pacientes con asma severa (90 % de mujeres y media de edad de 49.1 años), la evolución del diagnóstico de asma severa osciló entre uno y 24 años (promedio de 8.3 años). Todos presentaron al menos una prueba cutánea o IgE específica positiva a un aeroalérgeno, determinación de IgE total y espirometría. Al inicio y a las 52 semanas de aplicar el omalizumab (dosis promedio de 550 mg, con aplicación quincenal o mensual), se aplicó el mini-AQLQ y se obtuvo el volumen espiratorio forzado al primer segundo (VEF1). Resultados: Hubo mejoría significativa (p = 0.013) en el mini-AQLQ después de 52 semanas, con puntuación global de 4.5, principalmente en las dimensiones de emociones (p = 0.0073) y en la ambiental (p = 0.00014). No hubo cambios significativos del VEF1. En 63 % de los pacientes se observó obesidad y en 26 % sobrepeso. Conclusiones: El omalizumab mejoró la calidad de vida de los pacientes, sin cambios significativos del VEF1, probablemente por la obesidad.

Keywords: Allergic asthma; Omalizumab; Quality of life.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / immunology
  • Asthma / physiopathology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Omalizumab / therapeutic use*
  • Quality of Life*
  • Self Report
  • Severity of Illness Index
  • Spirometry
  • Young Adult

Substances

  • Anti-Asthmatic Agents
  • Omalizumab