Allergy and Airway: Asthma I |

The Use of Omalizumab in Thetreatment of Nasal Polyps FREE TO VIEW

Anna Yakinthou, PhD; Drosos Tsavlis, PhD; Ioannis Megas, MD
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Aristotle University of Thessaloniki, Thessaloniki, Greece

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A7. doi:10.1016/j.chest.2016.02.009
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Allergic rhinitis and nasal polyps are associated with elevated serum immunoglobulin IgE levels. The allergens bind to IgE on the surface of basophils and mast cells, which releases histamine, leukotriens and others, following the symptoms of allergic rhinitis. Does the removal of free IgE by the anti-IgE antibody, omalizumab, improve the symptoms of allergic rhinitis and reduce nasal polyps? The answer to that question was the aim of this study.

METHODS: Fifty patients, 20 women and 30 men, all suffering from allergic rhinitis and asthma with mean body weight 82 kgs underwent rhinoscopic endoscopy, computed tomography of the nose and the ethmoid cells and spirometry. These tests took place twice. First time on day 0 and second time sixteen weeks after subcutaneous omalizumab administration in doses depending on the body weight and the serum levels of total IgE of each patient with 2 or 4 week intervals. The mean omalizumab doses were: 300mg every 2 weeks or 450mg every 4 weeks.

RESULTS: The rhinoscopic endoscopy, on day 0, revealed nasal polyps. The computer tomography showed extended polypodiasis to 30 out of 50 patients (60%). The other 20 had only polyps in the ethmoid cells (40%). The FEV1 mean value was 68.6%. Sixteen weeks later we had an endoscopical and imaging reduction in nasal polyps and an improvement in the values of FEV1 in all patients (78.3%). The patients reported reduced use of corticoid sprays and an improvement in their quality of life, due to reduction of nasal symptoms of sneezing, itching, rhinorrhea and congestion. They all reported better sense of smell.

CONCLUSIONS: Omalizumab is effective in the symptoms of nasal congestion, anterior rhinorrhea, loss of smell, wheezing and dyspnea. It has been proved that Omalizumab reduces the size of nasal polyps and improves the quality of life. This finding could be due to the local formation of IgE in nose and lungs.

CLINICAL IMPLICATIONS: Omalizumab could by no means help a large number of patients with nasal polyps.

DISCLOSURE: The following authors have nothing to disclose: Anna Yakinthou, Drosos Tsavlis, Ioannis Megas

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