The effectiveness of anti-IgE therapy for allergic rhinitis in patients with severe atopic bronchial asthma and concomitant allergic rhinitis in real clinical practice
- Authors: Kiseleva D.V.1, Beltyukov E.K.1, Naumova V.V.1
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Affiliations:
- Ural State Medical University
- Issue: Vol 19, No 3 (2022)
- Pages: 289-298
- Section: Original studies
- URL: https://rusalljournal.ru/raj/article/view/1533
- DOI: https://doi.org/10.36691/RJA1533
Cite item
Abstract
BACKGROUND: Omalizumab, by binding immunoglobulin (Ig) E in patients with atopic asthma, can improve clinical and functional parameters and patients’ quality of life.
AIM: To evaluate the efficacy of anti-IgE therapy in patients with allergic rhinitis treated with omalizumab for concomitant severe atopic asthma in real clinical practice
MATERIALS AND METHODS: This open, non-interventional, prospective, and non-randomized study in real clinical practice was conducted in the Sverdlovsk region in October 2021 based on a regional registry of adult patients with severe asthma with chronic nasal inflammatory diseases and receiving targeted therapy. Dynamics of nasal symptoms were assessed using the Sino-nasal-outcome test 22 (SNOT-22) questionnaire and visual analog scale (VAS) initially and after 4 and 12 months of omalizumab therapy. Peripheral blood eosinophil level was assessed before and after 4 months of omalizumab therapy.
RESULTS: The study included 26 patients. Assessment of nasal symptoms dynamics using the SNOT-22 questionnaire at baseline and after 4 months of omalizumab therapy revealed a decreased severity of symptoms (p <0.001) of 46.85±22.04 points at baseline (95% confidence interval [CI]: 37.94–55.75) and 30.65±14.81 points after 4 months (95% CI: 24.67–36.64). Additionally, improvement in SNOT-22 questionnaire score was revealed in 18 patients treated with omalizumab during 12 months, with 47.5 points before therapy (Q₁–Q₃: 35.7–59.3), 30.4 points after 4 months (Q₁–Q₃: 22.1–38.1), and 24.9 points after 12 months (Q₁–Q₃: 16.9–32.9) (p=0.001). Improvement in rhinitis symptoms control was observed according to the VAS scale, with 8.0 points before therapy (Q₁–Q₃: 6.2–9.0), 5.0 points after 4 months (Q₁–Q₃: 3.2–5.8), and 5.0 points after 12 months of treatment (Q₁–Q₃: 4.0–6.8). The eosinophil levels (n=16) decreased from 510.9±317.9 cells/µl (95% CI: 341.5–680.3) to 327.4±217.7 cells/µl (95% CI: 211.4–443.5) after 4 months of anti-IgE therapy (p <0.041).
CONCLUSIONS: Omalizumab in real clinical practice has demonstrated improvement of rhinitis symptoms and quality of life in patients with allergic rhinitis with concomitant severe atopic asthma. Additionally, a statistically significant decrease in peripheral blood eosinophils level was observed, which largely determines airway inflammation severity and clinical manifestations of allergic rhinitis and bronchial asthma.
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About the authors
Darina V. Kiseleva
Ural State Medical University
Author for correspondence.
Email: darinakiseljova@mail.ru
ORCID iD: 0000-0002-7847-5415
SPIN-code: 9446-7866
ResearcherId: AGI-2417-2022
MD
Russian Federation, EkaterinburgEvgeny K. Beltyukov
Ural State Medical University
Email: asthma@mail.ru
ORCID iD: 0000-0003-2485-2243
SPIN-code: 6987-1057
Scopus Author ID: 6504558662
ResearcherId: AAI-1608-2020
MD, Dr. Sci. (Med.), Professor
Russian Federation, EkaterinburgVeronika V. Naumova
Ural State Medical University
Email: nika.naumova@gmail.com
ORCID iD: 0000-0002-3028-2657
SPIN-code: 8210-6478
ResearcherId: AAI-1588-2020
MD, Cand. Sci. (Med.)
Russian Federation, EkaterinburgReferences
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