Omalizumab (ANTİ-IGE) tedavisinin hipereozinofilik olan ve olmayan alerjik astımlı hastalarda etkinliğinin retrospektif olarak karşılaştırılması

Asthma is an inflammatory airway disease involving various inflammatory cells and many mediators; which causes reorganization of airway (remodeling), mucus hypersecretion, airway hypersensitivity and bronchospasm. Type 2 inflammation that develops in an asthmatic patient contains cytokines such as IL-4, IL-5, IL-9, IL-13 which are released due to the activation of Thelper 2 or Type 2 ILC cells, specific IgE is produced by B lymphocytes in response to allergens and / or eosinophils are heavily involved. Severe asthmatics who do not have sufficient clinical response despite optimum treatment should be phenotyped. They are recommended to be given Anti-IgE if they are atopic and Anti-IL-5 if they are hypereosinophilic. In overlap patients who are suitable for both biological agents, there is not enough data for the selection of the agent. Our aim in this study is to find out the reliability and effectiveness of omalizumab therapy in patients with uncontrolled severe allergic asthma. Furthermore, we compare the effects of omalizumab in hypereosinophilic and normoeosinophilic asthmatics. In this study, 116 patients from Uludağ University Medical Faculty Chest Diseases Immunology Allergy Outpatient Clinic with severe allergic asthma who received omalizumab treatment were included. Patients who are all atopic, were divided into two groups according v to the number of eosinophils below and above 300, respectively. With omalizumab treatment, a significant decrease in the number of attacks and a significant increase in AKT scores were found. In the patients with the eosinophil number less than 300, the increase in FEV1 level was not found to be significant. However, a significant increase in FEV1 level was found in the patients with eosinophil number larger than 300. In both groups, significant increase was observed in the PEFmeter values. In the 4th month of omalizumab treatment, the decrease in the number of attacks as well as the increase in spirometry values and ACT score were found to be similar in both groups. Our work concludes that omalizumab is as effective in hypereosinophilic overlap patients as in those with low eosinophilia.