Introduction: Allergic Bronchopulmonary Aspergillosis (ABPA) is a common condition in patients with Cystic Fibrosis (CF), characterized by Th2 response and increased total serum IgE. ABPA occurs in 2–25% of patients with CF, significantly higher in adults when compared to children. Omalizumab is a humanized recombinant monoclonal antibody, approved as a steroid sparing agent for severe allergic asthma. The aim of our study was to explore the effectiveness of omalizumab to treat ABPA in patients CF.
Methods: A retrospective study was performed in three CF centers. Inclusion criteria were CF patients with diagnosis of ABPA. Main outcome parameters were: FEV1, BMI, pulmonary exacerbations (PEx) and steroid sparing effect.
Results: We describe 9 patients, 6 males and 3 females, average age 23 years, regarding FEV1, only 1 showed an improvement, 4 patients had a stable FEV1 and 4 (all with CFRD) had a decreased FEV1. Reduction in BMI was recorded in 4 patients, 3 were stable and 2 improved. During treatment patients experienced a mean of 4 PEx per patient or 0.288 PEx per month of treatment. Steroid dosage could not be reduced during treatment in any of the patients. Post treatment IgE levels decreased in 6 patients and increased in 3. Those with elevated levels had better outcome and had no PEx.
Conclusions: Omalizumab did not seem to improve any of the 4 parameters evaluated. CFRD and male gender seemed to be associated with a worse ABPA disease course. Decrease in IgE during treatment wasn`t associated with clinical improvement.
