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Adding a biologic to allergen immunotherapy increases treatment efficacy.

Andrzej Bożek1, Andreas Fischer2, Agnieszka Bogacz-Piaseczynska1

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Combining allergen immunotherapy (AIT) with omalizumab significantly improves treatment for house dust mite (HDM)-driven asthma. This combination therapy enhances asthma control and reduces inhaled corticosteroid use more effectively than AIT alone.

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Area of Science:

  • Allergy and Immunology
  • Respiratory Medicine
  • Pharmacology

Background:

  • Allergen immunotherapy (AIT) combined with biological agents enhances safety and efficacy in allergies.
  • House dust mite (HDM)-driven asthma is a common condition requiring effective treatment strategies.

Purpose of the Study:

  • To compare the effectiveness of AIT in patients with HDM-driven asthma, with and without omalizumab treatment.
  • To evaluate the synergistic effects of combining HDM subcutaneous immunotherapy (SCIT-HDM) with omalizumab.

Main Methods:

  • A 12-month, placebo-controlled, three-armed, randomized multicentre trial involving 52 patients with HDM monosensitisation.
  • Therapy groups included: omalizumab alone, SCIT-HDM + omalizumab, and SCIT alone.
  • Primary outcomes: Asthma Control Questionnaire (ACQ) score, asthma exacerbations, and daily inhaled corticosteroid dose.

Main Results:

  • All treatment groups showed significant improvements in ACQ scores and reduced asthma exacerbations.
  • A statistically significant reduction in inhaled corticosteroid doses was observed in the omalizumab alone and SCIT-HDM + omalizumab groups.
  • The combination of SCIT-HDM and omalizumab demonstrated a greater reduction in inhaled corticosteroid doses compared to omalizumab alone.

Conclusions:

  • The combination of allergen immunotherapy with omalizumab significantly enhances the efficacy of treatment for HDM-driven asthma.
  • Combining SCIT-HDM with omalizumab offers superior benefits in reducing inhaled corticosteroid requirements.