Lung function parameters in omalizumab responder patients: an interesting tool?

Abstract

Background

Omalizumab, an anti-IgE antibody, is used to treat patients with severe allergic asthma. The evolution of lung function parameters over time and the difference between omalizumab responder and non-responder patients remain inconclusive. The objective of this real-life study was to compare the changes in FEV1 of omalizumab responders and non-responders at 6 months.

Methods

A multicenter analysis was performed in 10 secondary and tertiary institutions. Lung function parameters (forced vital capacity (FVC), pre- and post-bronchodilator FEV1, residual volume (RV) and total lung capacity (TLC) were determined at baseline and at 6 months. Omalizumab response was assessed at the 6-month visit. In the omalizumab responder patients, lung function parameters were also obtained at 12, 18 and 24 months.

Results

Mean pre-bronchodilator FEV1 showed improvement in responders at 6 months, while a decrease was observed in non-responders (+0.2 ± 0.4L and -0.1 ± 0.4L respectively, p<0.01). After an improvement at 6 months, pre- and post-bronchodilator FEV1 remained stable at 12, 18 and 24 months. The FEV1/FVC remained unchanged over time, but the proportion of patients with an FEV1/FVC ratio < 0.7 decreased at 6, 12, 18 and 24 months (55.2%, 54.0%, 54.0% and 44.8%, respectively, p<0.05). Mean RV values decreased at 6 months but increased at 12 months and 24 months (p<0.05). RV/TLC ratio decreased at 6 months and remained unchanged at 24 months.

Conclusion

After omalizumab initiation, FEV1 improved at 6 months in responder patients and then remained stable for 2 years. RV and RV/TLC improved at 6 months.

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