Evaluation of the efficacy of omalizumab retreatment in severe asthma

Introduction Severe asthma creates a heavy burden for the economy of countries due to the costs associated with treatment and loss of labor for the patient and physician due to the difficulties in treatment. Omalizumab treatment in severe asthmatic patients is increasing recently. Although the efficacy of omalizumab treatment in patients with severe asthmatic patients has been demonstrated in many studies, the number of studies that are discontinued and then retreatment are low. Aim A proportion of asthma patients who used omalizumab and discontinued treatment for any reason have a recurrence of asthma symptoms at follow-up. In these patients, it may be necessary to restart omalizumab treatment. In our study, we aimed to evaluate the efficacy of omalizumab retreatment in patients who quit for any reason after receiving omalizumab treatment. Patients and Methods Patients who received omalizumab treatment for at least two years, the treatment was shown to be successful, and the patients who received omalizumab for at least one year in the second treatment were included in the study.Sociodemographic data were recorded. Asthma medications, pulmonary function tests, asthma control test scores of the patients both before and after the first treatment and before and after the second treatment; asthma attacks, asthma attacks requiring systemic corticosteroid use, systemic corticosteroid treatment, unplanned doctor visits, emergency room admissions and hospitalizations in a year were recorded. Immunoglobulin E (IgE) values before the first and second treatment and the side effects of both treatments were recorded. Results A total of 36 patients with a diagnosis of severe persistent asthma were included in our study. The mean age of the patients was 53.39.7, of which 27 were female and nine were male. The most common reason for discontinuing treatment was patient request. Treatment was terminated for this reason in 26 patients. The time to start treatment again was 16.510.1 months. After retreatment, patients' asthma control test score and the number of asthma attacks, asthma attacks requiring systemic corticosteroid use, systemic corticosteroid treatment, unplanned doctor visits, emergency room admissions and hospitalizations in a year were evaluated. A statistically significant decrease was observed in. (p<0.05) Although the retreatment doses of the cases were lower than the previous treatments, it was not statistically significant. Despite the response to the first treatment in three of the cases, there was no response to the retreatment. On a case-by-case basis, retreatment doses were lower in these three cases compared to the first treatment. In terms of side effects, no serious side effects were observed in any of the patients and the side effects were like those in the first treatment. Discussion and Conclusion Many asthma patients who respond well to omalizumab treatment lose control of their asthma again after the drug is stopped. The effectiveness, safety and patient selection criteria of retreatment are of great importance for these patients. The effectiveness of retreatment for this drug, which is so unknown even about the duration of treatment, is a very current and important issue. In our study, omalizumab was found to be effective and safe in retreatment in severe asthma patients. Our study will shed light on new studies involving more cases to be conducted on omalizumab retreatment.