Beneficial effects of Omalizumab therapy in allergic bronchopulmonary aspergillosis: A synthesis review of published literature

Respir Med. 2017 Jan:122:33-42. doi: 10.1016/j.rmed.2016.11.019. Epub 2016 Nov 26.

Abstract

Omalizumab, a humanized mAb that binds to IgE, has been an effective therapy for patients with severe allergic asthma; however, there are few clinical trials examining the efficacy of Omalizumab in patients with allergic bronchopulmonary aspergillosis (ABPA) except some case reports. To assess the clinical and immunological effects of Omalizumab in ABPA patients, we made a synthesis review of 102 cases from 30 published literature, analyzed the effects of Omalizumab therapy in ABPA and conducted subgroup analyses to determine factors that influenced the therapy endpoints. We found that Omalizumab treatment not only provided a clinically important reduction in serum IgE, exacerbation rates and steroid requirement, but also showed attenuated asthma symptoms and improved pulmonary function parameters in patients with ABPA. Moreover, further discussion was made when interpretating the results. Double-blind, randomized, placebo-controlled trials are necessary to establish the efficacy and safety of this novel therapeutic intervention for ABPA patients.

Keywords: Allergy bronchopulmonary aspergillosis; Aspergillus fumigates; Omalizumab; Prednisone dosage; exacerbation.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Allergic Agents / administration & dosage
  • Anti-Allergic Agents / pharmacology*
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / pharmacology*
  • Aspergillosis, Allergic Bronchopulmonary / drug therapy
  • Aspergillus fumigatus / drug effects*
  • Asthma / drug therapy
  • Asthma / prevention & control
  • Child
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin E / drug effects
  • Male
  • Middle Aged
  • Omalizumab / administration & dosage
  • Omalizumab / pharmacology*
  • Treatment Outcome

Substances

  • Anti-Allergic Agents
  • Antibodies, Monoclonal, Humanized
  • Omalizumab
  • Immunoglobulin E