Impact of omalizumab therapy on medication requirements for chronic rhinosinusitis.

Chandra RK, Clavenna M, Samuelson M, Tanner SB, Turner JH
Int Forum Allergy Rhinol. 2016 6 (5): 472-7

PMID: 26679299 · DOI:10.1002/alr.21685

BACKGROUND - Omalizumab is indicated for treatment of patients with moderate to severe allergic asthma. Previous studies have shown 70% of these patients also have chronic rhinosinusitis (CRS). The present series examines the impact of omalizumab on medication use for CRS in a cohort of asthmatic CRS patients who received this therapy.

METHODS - The sample included 25 patients with adequate prescription data preinitiation and postinitiation of therapy. Data was available for a full 12 months both preinitiation and postinitiation of therapy in 20 of 25 patients and for 4 to 8 months in the remaining 5 of 25. Average antibiotic use (# of unique prescriptions per month) and systemic steroid dose (mg/month) were tabulated for each patient and compared before and after initiation of therapy.

RESULTS - Mean antibiotic prescriptions/month decreased by 37%, and this was statistically significant (p = 0.013). Antibiotic use decreased in 15 of 25 (60%), was the same in 7 of 25 (28%), and increased in 3 of 25 (12%) patients. Chronic steroid administration was required in 19 of 25 patients, and dosing was highly variable. Mean monthly steroid dose decreased substantially in 8 of 19 (42%) patients, with reduction ranging from 40% to 100% from pretreatment levels. A modest decrease of 17% to 30% was observed in 4 of 19 (21%) patients. Steroid use was essentially unchanged in 4 of 19 (21%), but dramatically increased (71% to 366% above pretreatment dose) in 3 of 19 (15%) patients.

CONCLUSION - Omalizumab therapy is associated with a decrease in overall antibiotic use for CRS. A subset of patients also experience significant reduction in steroid dependence. Further study is necessary to determine factors predictive of response.

© 2015 ARS-AAOA, LLC.

MeSH Terms (14)

Adrenal Cortex Hormones Adult Anti-Allergic Agents Anti-Asthmatic Agents Anti-Bacterial Agents Chronic Disease Drug Utilization Female Humans Male Middle Aged Omalizumab Rhinitis Sinusitis

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