Allergic Bronchopulmonary Aspergillosis: A Clinical Evaluation of 15 Patients and Successful Omalizumab Treatment of Five Patients

Abstract

Objective: Allergic bronchopulmonary aspergillosis (ABPA) is an immunological lung disease caused by hypersensitivity reactions to Aspergillus antigen. Studies on the efficacy of omalizumab treatment in patients diagnosed with ABPA are limited to case reports and small series. Our aim was to evaluate the effectiveness of omalizumab treatment in ABPA in addition to clinical, radiological and serological characteristics these patients. Materials and Methods: This study is a prospective observational one. It included clinical review of 15 patients diagnosed with ABPA and the successful omalizumab treatment of 5 of these patients. Patients receiving omalizumab therapy were assessed at baseline, after 1 year and 3 years of starting treatment. Results: 15 patients (9 males, 6 females, mean age: 48.26 ± 9.92 years) diagnosed as ABPA were enrolled. One patient had received antituberculosis medications prior to diagnosis. The mean serum total IgE level was 1665 ± 909 IU/mL. The most common finding in thorax high-resolution computed tomography was central bronchiectasis. Omalizumab treatment was started in five patients with asthma and ABPA who have failed to respond to Global Initiative for Asthma step 4 treatment. Conclusion: ABPA should be considered in patients with uncontrolled or severe asthma, despite appropriate asthmatic treatment. Recognizing ABPA is important, because early diagnosis can delay the development or prevent the bronchiectasis that causes fibrotic lung disease. Omalizumab is an effective therapy option in patients with asthma and ABPA who fail to respond to Global Initiative for Asthma step 4 treatment.