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Omalizumab in eosinophilic granulomatosis with polyangiitis: friend or foe? A systematic literature review


1, 2, 3, 4, 5, 6

 

  1. Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy. fabiobasta@libero.it
  2. Department of Immuno-Rheumatology, Campus Bio-Medico, University of Rome, Italy.
  3. Allergy Unit, Università Cattolica del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
  4. Allergy Unit, Università Cattolica del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
  5. Department of Immuno-Rheumatology, Campus Bio-Medico, University of Rome, Italy.
  6. Unit of Geriatrics, Campus Bio-Medico University, Rome, Italy.

CER12570
2020 Vol.38, N°2 ,Suppl.124
PI 0214, PF 0220
Reviews

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PMID: 32083537 [PubMed]

Received: 04/07/2019
Accepted : 25/11/2019
In Press: 18/02/2020
Published: 22/05/2020

Abstract

OBJECTIVES:
To systematically evaluate, through a Medline search, the role of omalizumab in eosinophilic granulomatosis with polyangiitis (EGPA).
METHODS:
A systematic review was performed with the following inclusion criteria: original articles and case reports written in English and reporting an association between omalizumab and EGPA.
RESULTS:
We found 18 papers on EGPA (14 case reports, 3 retrospective cohort studies, 1 prospective cohort study). Omalizumab showed to be effective as corticosteroid-sparing agent in EGPA patients with severe asthmatic manifestations. On the contrary, conflicting results concerned its use in refractory forms of EGPA. Plausible is the increased risk of EGPA onset among asthmatic patients treated with omalizumab, probably related to steroid reduction, even if it cannot be excluded that omalizumab might be occasionally directly involved in the pathogenesis.
CONCLUSIONS:
Our findings support the use of omalizumab in selected forms of EGPA, but caution in the tapering of corticosteroids is also recommended. Quality of evidence is limited, as the source of information was mainly case reports. Clinical trials are required in order to evaluate the role of omalizumab in EGPA and to ascertain the risk of asthmatic patients given omalizumab to develop EGPA.

Rheumatology Article