The Efficacy of Omalizumab in Patients with Chronic Rhinosinusitis with Nasal Polyps and Comorbid Severe Allergic Asthma

Emel Atayik; Gokhan Aytekin; Isa Aydin; Ethem Omeroglu

doi:10.18502/ijaai.v23i3.15635

Emel Atayik Department of Allergy and Clinical Immunology, Konya City Hospital, University of Health Sciences, Konya, Turkey
Gokhan Aytekin Department of Allergy and Clinical Immunology, Konya City Hospital, University of Health Sciences, Konya, Turkey
Isa Aydin Department of ENT, University of Health Sciences, Konya City Hospital, Konya, Turkey
Ethem Omeroglu Department of Pathology, Konya City Hospital, University of Health Sciences, Konya, Turkey

DOI: https://doi.org/10.18502/ijaai.v23i3.15635

Keywords: Allergy; Asthma; Nasal polyps; Omalizumab; Sinusitis chronic

Abstract

Chronic rhinosinusitis whit nasal polyps (CRSwNP) is the most common comorbid disease accompanying asthma. Omalizumab is a recombinant anti-immunoglobulin (Ig) E antibody, and studies suggest that omalizumab may also affect CRSwNP regardless of asthma. We aimed to assess the effect of omalizumab treatment on CRSwNP accompanying severe allergic asthma (SAA) patients.

Clinical data including spirometry measurements, serum/nasal secretion biomarker levels were collected. NP scores and CRS scores (Lund-Mancay [LM] scores) were also recorded before omalizumab treatment, as well as at the 4th and 12th months of omalizumab treatment.

Twenty-one patients with both CRSwNP and SAA who underwent omalizumab therapy were assessed. There was a significant difference among forced expiratory volume (FEV1), ACT scores, NP scores, LM scores, serum IgE, and blood eosinophil levels of the patients before omalizumab therapy at the 4th and 12th months of omalizumab treatment. A significant negative correlation was observed between ∆FEV1 and ∆NP scores (r=−0.485), between ∆ACT and ∆NP scores (r=−0.469), and ∆ACT and ∆LM scores (r=−0.436). When we grouped the patients who benefited from 1 year of omalizumab therapy and those who did not in terms of NP, there was no difference between the two groups related to local eosinophil and local IgE levels in the nasal polyp biopsy.

Omalizumab treatment is effective for asthma and CRSwNP in patients with CRSwNP accompanied by SAA. Improvement in asthma is associated with improvement in CRSwNP. The efficacy of omalizumab on NP in patients with CRSwNP accompanied by SAA is independent of local IgE and eosinophil counts.