Pulmonology Xagena

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Asthmatic patients: Omalizumab therapy can be associated nasal polyposis

Omalizumab ( Xolair ) has been recommended as an add-on option for the treatment of patients with moderate-severe allergic asthma uncontrolled with high doses of corticoid inhaled therapy. In addition, some of these patients have also nasal polyposis and/or NSAID intolerance.

The aim of this study was to evaluate clinical evolution of nasal polyposis in Omalizumab-treated asthmatic patients.

A retrospective analysis of nasal polyposis symptoms in a case series of 12 adult patients ( ratio F/M, 1.4; median age, 48 years ) having asthma and treated with Omalizumab ( from 8 months to 5 years ) was carried out.
The diagnosis of nasal polyposis was confirmed by CT scan and/or nasofibroscopy.
NSAID intolerance was established in 9 patients by bronchial/oral provocation tests.
The progression of nasal polyposis symptoms was assessed by a visual analogue scale ( VAS ), the Sino Nasal Outcome Test ( SNOT 22 ), smell disorders ( anosmia / hyposmia ), and oral corticosteroids courses.

The median of the nasal polyposis symptoms on visual analogue scale was modified from 9 to 3 ( n=7 ), after the therapy with Omalizumab.

SNOT punctuation ( n=7 ) ranged from 4 to 37 ( 21; median ), while before treatment was 46 to 110 ( 65; median ).

Anosmia was reported by all subjects before treatment with Omalizumab, but only by 3 patients after therapy.

In 9 out of 12 patients the number of oral corticosteroids courses was reduced and just one patient needed the same amount of oral corticosteroids as before.

In conclusion, Omalizumab therapy in asthmatic patients could have some additional influences in the clinical evolution of associated nasal polyposis. ( Xagena )

Antón-Laiseca A et al, AAAAI Meeting, 2014