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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

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Factors reducing omalizumab response in severe asthma.

B Sposato¹, M Scalese², M Milanese³

¹Pneumology Department, Misericordia Hospital, Grosseto, Italy.

European Journal of Internal Medicine

|February 4, 2018

Summary

Several factors including age, obesity, comorbidities, smoking, nasal polyps, and allergic sensitization can reduce the effectiveness of Omalizumab therapy in severe asthmatics, impacting disease control and treatment outcomes.

Keywords:

Age Comorbidities Obesity Omalizumab Real-life Severe asthma Therapeutic response

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Area of Science:

Pulmonology
Allergology
Clinical Immunology

Background:

Severe asthma remains poorly controlled in some patients despite Omalizumab treatment.
Investigating factors influencing Omalizumab response is crucial for optimizing therapy.

Purpose of the Study:

To identify factors associated with reduced Omalizumab response in severe asthmatics.
To understand predictors of poor disease control and treatment outcomes.

Main Methods:

Retrospective evaluation of 340 severe asthmatic patients treated with Omalizumab.
Analysis of clinical parameters including lung function (FEV1%, FVC%), Asthma Control Test (ACT), fractional exhaled nitric oxide (FENO), exacerbations, and medication use.

Main Results:

Age, obesity, comorbidities, smoking, nasal polyps, and allergic co-sensitizations were associated with reduced Omalizumab effectiveness.
Obesity significantly increased exacerbations, partial/no disease control, and short-acting beta-agonist (SABA) use.
Comorbidities, particularly chronic heart disease and gastroesophageal reflux, negatively impacted asthma control and lung function.

Conclusions:

Factors such as age, obesity, comorbidities, smoking, nasal polyps, and allergic sensitization independently reduce Omalizumab effectiveness.
Identifying these factors can guide personalized treatment strategies for severe asthma.