Avaliação dos pacientes com asma grave do ambulatório de pneumologia do Hospital Universitário de Santa Maria em uso de omalizumabe

Abstract

Severe asthma is a complex syndrome and an important global health problem that requires an integrated therapeutic approach. With this in mind, the aim of the present study was to clinically and functionally evaluate adult patients with severe uncontrolled allergic asthma, treated at the pulmonology service of the University Hospital of Santa Maria (HUSM), of the Federal University of Santa Maria (UFSM), by using omalizumab. This is a retrospective, cross-sectional and descriptive study, with data obtained through the analysis of medical records. The sample was obtained from the HUSM/UFSM pulmonology service database. Patients using omalizumab, a humanized anti-IgE monoclonal antibody, indicated in patients with severe uncontrolled allergic asthma, were included in the study, after a systematic review of treatment adherence, correct medication inhalation technique, environmental control and treatment of comorbidities. Clinical, functional, and laboratory data from 13 patients were evaluated at 16, 32, and 54 weeks after starting medication. Such data were correlated with asthma control outcomes, measured by the Asthma Control Test (ACT) and by pulmonary function, analyzing forced expiratory volume in one second (FEV1), measured by spirometry and the number of exacerbations. The average age was 50.6 years (ranging from 31 to 64 years), 12 individuals were female, 1 male, there were no active smokers, and seven were obese. In eight of the subjects, symptoms had already started. ACT averaged 9.4 points at the initial or baseline assessment, increasing to 17 points after 54 weeks, and FEV1 averaged 1.50 liters at initial or baseline assessment and 1.90 liters after 54 weeks. In both cases data showed a significant variation, both from a statistical point of view (p = 0.04 for ACT and p = 0.02 for FEV1) and from a clinical point of view (increase of more than three points in ACT and more than 100 ml on FEV1). It was not possible to assess the number of exacerbations. The study is in agreement with previous findings in the literature regarding the results of the use of omalizumab in patients with severe uncontrolled allergic asthma.