Asthma exacerbations after discontinuation of omalizumab treatment

Introduction. Omalizumab has a well-established role in treating severe allergic asthma. Despite many years of experience and research on the drug the optimal duration of treatment with anti-IgE has not been determined yet. Literature data on the subject reports cases of loss of asthma control after cessation of treatment, regardless of its duration. Aim. The aim of the study was to assess the course of the disease in five patients treated with omalizumab for over five years, who did not receive the continuation of the existing biological treatment in 2013 for procedural reasons. Materials and methods. During 18 weeks of observation, the study group was evaluated for clinical condition, pulmonary function parameters (FEV1), nitric oxide concentration in exhaled air (FeNO), number of hospitalizations, doses of inhaled glucocorticosteroids (ICS), number of exacerbations, necessity to add systemic glucocorticosteroids (OCS) and rescue medication consumption. Results. A decrease in respiratory parameters, an increase in rescue medication consumption and the mean dose of inhaled glucocorticosteroids was observed in the entire study group. Three cases presented with loss of disease control and two patients had systemic steroids added to the treatment. Conclusions. The possibility of asthma exacerbations after omalizumab discontinuation is relatively high and therefore patients should be closely monitored for disease progression as well as considered for requalification for anti-IgE treatment.