The effect of omalizumab on blood eosinophils count in patients with hypersensitivity to non-steroidal anti-inflammatory drugs (NSAID) compare to patients who tolerate NSAID–pilot study

Hypersensitivity to non-steroidal anti-inflammatory drugs(NSAID) is a distinct phenomenon of severe asthma. Eosinophils play a key role in NSAID hypersensitivity as a main source of prostanoides. The aim of the analysis is to assess the effect of omalizumab(OMA) on blood eosinophils count(Eo) in asthmatic patients with NSAID hypersensitivity compare to those who tolerate NSAID(non-NSAID). Out of 38 patients who started OMA therapy the positive history of NSAID hypersensitivity was reported by 14 patients, 24 tolerated NSAID. We evaluated Eo level and OMA clinical effectiveness in 16thweek and 52ndweek of therapy (P-value <0.05). The baseline characteristic(demographic data, asthma severity) did not differ between study groups. The mean Eo did not differ between study groups at the baseline (mean±SD NSAID vs non-NSAID respectively: 578±681/μl vs 348±301/μl), although patients hypersensitive to NSAID had Eo≥500/μl almost 2 times more frequent. At 16thand 52ndweek the mean Eo did not change significantly. 4 patients(NSAID/non-NSAID=2/2) stopped the therapy due to subjective lack of benefit. In both groups, we observed significant improvement in ACQ and AQLQ scale, the reduction of annual exacerbations rate and the daily OCS dose in 16th and 52nd week. The improvement in asthma control parameters in 16thand 52ndweek did not differ between study groups. OMA therapy did not affect Eo blood in patients with NSAID-intolerance, regardless of good clinical response. OMA seems to be effective in patients suffering from severe allergic asthma independently of NSAID hypersensitivity status.(2015/19/B/NZ5/00096)