Session Speaker

Effectiveness of Omalizumabin Children with Severe Asthma
Laura Valdesoiro
Spain


Introduction: Severe bronchial asthma is presently included in the group of difficult to control asthma. The therapeutic approach to these patients has recently changed since the marketing of Omalizumab, a monoclonal anti-IgE antibody which is recommended for the treatment of non-controlled asthma patients. Our Purpose is to show our experience of Omalizumab treatment in children with severe asthma.

Materials and Methods: Children with persistent non-controlled severe asthma, receiving the best standard care stated in the GINA referred to our service were admitted. Clinical and functional evaluation (spirometry, exhaled NO) and induced sputum were performed at entry and end of follow-up. Omalizumab was administered subcutaneously at the ambulatory care unit of our service and the dosage was calculated according to the following equation: IgE UI/ml x Kg weight x 0.016.

Results: 28 children, 16 (56%) boys/12 (44%) girls. Age: 11. 4 years (range: 2.6 - 14); 5 children were under 5 yrs. Duration of treatment: 1.7 yrs (range: 4 months – 46 months). IgE concentration: 480 IU/ml (range: 40 – 1910). In 5 out 28 cases, the IgE concentration exceeded 750 IU/ml. Patients’s weight 41.6 Kg (range: 15-63). All patients were treated with inhaled corticoids (Fluticasone 100 0mcg/12 h) and LABA (salmeterol 50mcg or formeterol 9mcg/12 h) and leukotriene modifiers (Montelukast: 5-10mg per day). 17 children (28):66% were received oral steroids from 16 - 60mg a day, 1 patient was treated with methotrexate; in 16/28 (58%), immunotherapy was started but needed to be stopped due to asthma exacerbation.

At the end of follow-up, FEV1 improved in 80% of the patients exhaled NO and eosinophils count in induced sputum decreased in 90% of the patients. The use of short beta- 2- agonist as rescue medication was reduced by 50%. Oral corticosteroids were withdrawn in all patients between 2 and 9 months respectively. Methotrexate could be withdrawn in the only treated patient. The number of exacerbations decreased to 66, 6%. Only one patient required hospital admission and there were only two non-programmed appointments. None relevant side effects were observed.
.