Korzyści z leczenia omalizumabem wykraczajÄ ce poza spodziewane efekty u 38-letniej chorej na ciężkÄ postać astmy alergicznej

We report the case of a 38-year-old woman suffering from allergic asthma since the age of 4. In the last 10 years, the patient presented with severe uncontrolled asthma with frequent exacerbations, despite stage-5 treatment according to GINA guidelines, including constant high doses of methylprednisolone. Long-time treatment with high doses of systemic corticosteroids induced many side effects including arterial hypertension, diabetes, GERD, hypercholesterolemia and obesity (weight 121 kg, height 176 cm, BMI 39 kg/m2). Despite the treatment, asthma control remained poor, and quality of life and lung function test results were low (ACQ: 4,71 p, miniAQLQ: 3,2 p, FEV1 2,04 L 60,3% pred., FEV1/FVC 60,85%). The patient was enrolled into the omalizumab treatment program in March 2014. After 24 months of omalizumab treatment, the dose of methylprednisolone was reduced by 30 mg/day. At the same time, asthma control and quality of life improved significantly (ACQ 1,85, miniAQLQ 4,73). Body weight was reduced by 30 kg (BMI 29 kg/m2) as well. Asthma exacerbation rate was also significantly reduced, and there was no asthma exacerbation in the last 12 months of the treatment. Unexpectedly, we observed improvement and further normalization of spirometry with finally normal FEV1/FVC ratio and FEV1 (FEV1 2,87 L 86,4% pred.). The patient has resumed her all daily-life activities.