PURPOSE: The Dutch Hypothesis has been used to suggest that Asthma and COPD may be considered as different expressions of one disease entity. The purpose of this study is to evaluate the role of Anti-IgE treatment in patients who have COPD with elevated IgE levels suggestive of atopy as a mechanism for initiation of their exacerbations.
METHODS: Patients (n=29) with a diagnosis of COPD from a Pulmonary Practice in Michigan were screened for elevated IgE levels and Michigan RAST Allery Panel. If they were symptomatic despite adequate conventional treatment and had elevated IgE levels, they were started on Omalizumab. Patients were on treatment for at least three months when they were asked to fill out a questionnaire from which their Symptoms Scores and Satisfaction Scores were extracted (Symptom Score is 1 to 3 and Satisfaction Score 1 to 11).
RESULTS: There was a significant improvement in the amelioration of symptoms and increase in satisfaction scores with treatment with Omalizumab. Symptoms Scores changed from 2 to 1.34. This difference was significant (p=8.74047E−06) with 2 being no change and 1 being improved. Satisfaction Scores changed from 6 to 9.41 with 6 being no change and less than 6 being worse and greater than 6 being improved. This difference was significant (p=1.50106E−11).
CONCLUSION: It may be important to evaluate the response of patients with COPD to the treatment with monoclonal Anti-IgE antibodies. There is a need for randomized placebo controlled, double blinded trials to help further define the role of monoclonal Anti-IgE antibodies in patients with COPD.
CLINICAL IMPLICATIONS: There seems to be considerable overlap between Asthma and COPD so it may be beneficial to use monoclonal Anti-IgE antibodies in patients with COPD who have elevated IgE levels. It may decrease patient symptoms and increase their quality of life. Use of monoclonal Anti-IgE antibodies may lead to economic benefit both direct and indirect to Hospitals and Health Care Systems by decreasing exacerbations, ER visits and hospitalizations in patients with COPD.
DISCLOSURE: Mary Zaremba, No Financial Disclosure Information; No Product/Research Disclosure Information