P18 Experience in application of omalizumab in patients with severe uncontrollable bronchial asthma in paediatric practice (a prospective study)

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Abstract

Materials and methods

13 children received anti-IgE therapy at our Clinic from 2008 to 2016. The study included taking clinical case history, laboratory instrumental and mathematic-statistic methods to analyse children, who went to the Clinic for injections 1 time per 2 weeks/ 1 time per 4 weeks. The number of injections was determined according to baseline level of total IgE and children’s baseline weight.

patient description.

13 children underwent anti-IgE therapy: 9 boys and 4 girls. At the beginning of the therapy all patients were diagnosed with atopic severe persistent uncontrollable bronchial asthma. All patients had polyvalent sensibilization. 9 (69.2%) patients were diagnosed with drug allergy. Age of bronchial asthma onset ranged between 1 and 11 years. Age at the beginning of the therapy – 6–17 years. Baseline level of total IgE ranged from 110–678 IU/ml. At the beginning of the therapy, all patients were receiving combined baseline therapy with high dose equivalent of fluticasone.

Assessment of therapy efficiency

After first six months, the therapy decreased the frequency of severe aggravations in all patients, and improved external respiration function: increased forced expiratory volume 1 (%) from 82.0±15.2 before therapy to 91.0±25.3, increased peak exhalation speed (%) from 78.2±24.5 to 81.0±14.8. All patients began to show less need for B-agonists, declined frequency of daytime asthmatic attack, improved exercise tolerance; not a single clinically significant aggravation of disease was observed. Disease management assessment (Asthma Control Test) increased from 14.6±1.4 ?? 18.6±1.1. The medication therapy was safe: none of the children experienced adverse effects from injections.

Conclusion

This data based on our internal experience of using Omalizumab as part of combined therapy for severe uncontrollable bronchial asthma treatment demonstrate the prospects for treatment of the most complicated group of patients. Improvement of disease management was achieved among all patients. However, taking into account pharmacological and economic features of anti-IgE therapy, a very stringent patient selection procedure should be in place of such therapy, and it may only be administered in case of severe uncontrollable course of the disease with proven atopic character and high risk of fatal asthma.

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