Steroid-sparing effect of omalizumab for allergic bronchopulmonary aspergillosis and cystic fibrosis.

Abstract:

:Allergic bronchopulmonary aspergillosis (ABPA) is a complication commonly encountered in patients with CF that produces significant respiratory morbidity. Chronic airway colonization with Aspergillus induces strong inflammatory responses with high IgE levels. Current guidelines for therapy include prolonged courses of systemic corticosteroids as the main therapeutic strategy. However this has the potential to induce significant detrimental side effects in children. Omalizumab is a humanized monoclonal antibody directed against IgE that prevents its binding to high- and low-affinity receptors on effector cells. It has been shown to be effective in improving asthma control in patients with a strong allergic component. We present our long term experience with the use of Anti-IgE therapy in three children with CF and ABPA (mean age at start of therapy 14.2 years) who were steroid dependent. All three were already experiencing significant side effects from chronic steroid therapy. After the start of Omalizumab these children have experienced significant and sustained clinical improvements at the same time that they were discontinued from chronic systemic steroids. Our experience suggests that IgE blockade has tremendous potential as a strategy to control this disease in steroid dependent patients.

journal_name

Pediatr Pulmonol

journal_title

Pediatric pulmonology

authors

Zirbes JM,Milla CE

doi

10.1002/ppul.20804

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

607-10

issue

6

eissn

8755-6863

issn

1099-0496

journal_volume

43

pub_type

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