Response to omalizumab therapy in a difficult to treat asthma cohort in Rio de Janeiro, Brazil

Asthma is a leading cause of respiratory morbidity and mortality worldwide, and its prevalence is increasing. A significant proportion of patients have poorly controlled asthma, despite treatment with high doses of inhaled and oral drugs. Difficult to treat asthma is defined as asthma uncontrolled with a reliever medication plus two or more controllers medications. Omalizumab is an option for patients with elevated serum levels of IgE with severe allergic asthma. Unfortunatelly, due to its high cost, it is still scarcely used in Brazil. We describe the response to omalizumab in a cohort of difficult to treat asthma patients in Rio de Janeiro, Brazil. Fifty patients are currently under omalizumab treatment. All of them, also with high doses of inhaled corticosteroids and long acting bronchodilators. The mean age of the cohort is 55 yrs, 78% are women, and 58% have moderate to severe obstruction in spirometry. Astma control improved and hospitalization rates was significantly reduced after the beggining of omalizumab. No severe adverse reactions were found. In conclusion, we were able to achieve an increased control of the disease and reduce the number of hospitalizations after the beggining of omalizumab therapy.