ABSTRACT

Introduction: The binomial term overlap asthma/COPD is a subset of patients with persistence and airflow limitation that presents clinical features of both asthma and COPD. Initial studies have shown that omalizumab may be useful in patients with ACOS, it has been shown to improve symptoms, reduce exacerbations and hospitalization, as well as improve lung function parameters and reduced steroid requirement in these patients. Objective: To describe the effect of omalizumab in 5 patients with a diagnosis of overlying asthma/COPD syndrome (OAC) and administration of omalizumab. We describe the experience of our center and the benefits that the treatment has given to our patients. Material and methods: We present 5 cases of patients with a diagnosis of overlap asthma/COPD syndrome after application of omalizumab (300 mg SC each month) significantly improved their symptoms in ACT (asthma control test) and respiratory function tests, mainly in spirometry. This 5 patients gave their consent to present cases. Results: The 5 patients with OAC received Omalizumab have experienced improvement of symptoms in ACT (asthma control test) and improvement of 10 to 20 and 25 points. Omalizumab was well tolerated without complications. 100% of patients showed improvement in symptoms (ACT), higher percentage are women as described in the literature, patients tolerated the treatment without presenting major adverse effects. Conclusion: The cases described offer initial evidence of our medical practice on the benefits of omalizumab in patients with clinically improving overlying asthma/COPD syndrome. Omalizumab demonstrates good tolerance without presenting adverse effects. These benefits have allowed the patient a better quality of life and radically reduce their morbidity.

KEYWORDS

Overlap asthma/COPD, omalizumab, treatment.

REFERENCES

1. Postma DS, Rabe KF. The asthma-COPD overlap syndrome. N Engl J Med 2015;373(13):1241-1249. doi: 10.1056/NEJMra1411863.

2. Sin DD, Miravitlles M, Mannino DM, et al. What is asthma-COPD overlap syndrome? Towards a consensus definition from a round table discussion. Eur Respir J 2016;48(3):664-673. doi: 10.1183/13993003.00436-2016.

3. Cosio BG, Soriano JB, López-Campos JL, et al.; CHAIN Study. Definiting the asthma-COPD overlap syndrome in COPD cohort. Chest 2016;149(1):45-52. doi: 10.1378/chest.15-1055.

4. Kiljander T, Helin T, Venho K, Jaakkola A, Lehtimäki L. Prevalence of asthma-COPD overlap syndrome among primary care asthmatics with a smoking history: a cross-sectional study. NPJ Prim care respire Med 2015;25:15047. doi: 10.1038/npjpcrm:2015.47.

5. Rodrigues D, Galego MA, Teixeira M, Vaz AP, Ferreira J. Characterization of ACOS patients in a pulmonary outpatient consultation-applying the questionnaire proposed by GINA/GOLD consensus. Eur Respir J 2016;48:PA869. doi: 10.1183/13993003.

6. Yalcin AD, Celik B, Yalcin AN. Omalizumab (anti-IgE) therapy in the asthma-COPD overlap syndrome (ACOS) and its effects on circulating cytokine levels. Immunopharmacol Immunotoxicol 2016;38(3):253-256. doi: 10.3109/08923973.2016.1173057.

7. Busse WW. Biologicals for asthma in patients with asthma-COPD overlap. The Lancet 2017;5(3):175-177. doi: https://doi.org/10.1016/S2213-2600(17)30055-3

8. Maltby S, Gibson PG, Powell H, McDonald VM. Omalizumab treatment response in a population with severe allergic asthma and overlapping COPD. Chest 2017;151(1):78-89. doi: 10.1016/j.chest.2016.09.035.

9. Nayci SA, Ozgur E, Tastekin E, Ozge C. Effectiveness of omalizumab treatment in asthma-COPD overlap syndrome. In: Chest 2016 Annual Meeting, 2016-10-12, 2016-10-26, Los Angeles, Cal. doi: http//dx-doi.org/101016/j.chest.2016.08.967

10. Dammert P, Jawahar D. Omalizumab in patients with COPD and atopic phenotype: a case series. Am J Respir Crit Care Med 2016;193:A6246.

11. Xia Y, Cao Y, Xia L, Li W, Shen H. Severe asthma and asthma-COPD overlap: a double agent or identical twins? J Thorac Dis 2017;9(12):4798-4805. doi: 10.21037/jtd.2017.11.113.