Review question

We reviewed the evidence about the effect of anti-IgE therapy for treating allergic bronchopulmonary aspergillosis in people with cystic fibrosis.

Background

Cystic fibrosis is a genetically inherited disease which is not uncommon in the Western World. Allergic bronchopulmonary aspergillosis is a lung disease caused by extreme sensitivity to aspergillus (a fungus) and may occur in 2% to 15% of people with cystic fibrosis. Corticosteroids and antifungal therapy are the mainstay of treatment for allergic bronchopulmonary aspergillosis, but lengthy or repeated use of corticosteroids may lead to serious side effects. Allergic bronchopulmonary aspergillosis occurs as a result of the action of IgE antibodies (a type of protein). A drug that acts against these IgE antibodies (anti-IgE therapy), such as omalizumab, may be a possible treatment for allergic bronchopulmonary aspergillosis in people with cystic fibrosis. The drug is given as an injection below the skin every two to four weeks. The review aimed to show whether anti-IgE therapy for allergic bronchopulmonary aspergillosis in people with cystic fibrosis is effective and to highlight any possible side effects.

Search date

The evidence is current to: 29 September 2017.

Study characteristics

We could only include one small study in the review (14 participants) and this was stopped early because not enough people agreed to join the study as volunteers. The study lasted six months and compared omalizumab (Xolair®) injections under the skin of the upper arm or the thigh to placebo injections (dummy treatment containing no active medication). Volunteers were given of 600 mg of omalizumab or placebo daily along with itraconazole (an antifungal drug) twice daily and oral corticosteroids, with a maximum daily dose of 400 mg.

Key results

The full results of the study were not published. Only limited results on side effects were published online. Six out of nine volunteers (66.67%) in the omalizumab group and one out of five volunteers (20%) in the placebo group reported one or more serious side effects.

Due to the lack of evidence, we are not able to make recommendations either in favour of, or against the use of, anti-IgE (omalizumab) therapy in people with cystic fibrosis and allergic bronchopulmonary aspergillosis. More research into this treatment is needed.

Review question

We reviewed the evidence about the effect of anti-IgE therapy for treating allergic bronchopulmonary aspergillosis in people with cystic fibrosis.

Background

Cystic fibrosis is a genetically inherited disease which is not uncommon in the Western World. Allergic bronchopulmonary aspergillosis is a lung disease caused by extreme sensitivity to aspergillus (a fungus) and may occur in 2% to 15% of people with cystic fibrosis. Corticosteroids and antifungal therapy are the mainstay of treatment for allergic bronchopulmonary aspergillosis, but lengthy or repeated use of corticosteroids may lead to serious side effects. Allergic bronchopulmonary aspergillosis occurs as a result of the action of IgE antibodies (a type of protein). A drug that acts against these IgE antibodies (anti-IgE therapy), such as omalizumab, may be a possible treatment for allergic bronchopulmonary aspergillosis in people with cystic fibrosis. The drug is given as an injection below the skin every two to four weeks. The review aimed to show whether anti-IgE therapy for allergic bronchopulmonary aspergillosis in people with cystic fibrosis is effective and to highlight any possible side effects.

Search date

The evidence is current to: 29 September 2017.

Study characteristics

We could only include one small study in the review (14 participants) and this was stopped early because not enough people agreed to join the study as volunteers. The study lasted six months and compared omalizumab (Xolair®) injections under the skin of the upper arm or the thigh to placebo injections (dummy treatment containing no active medication). Volunteers were given of 600 mg of omalizumab or placebo daily along with itraconazole (an antifungal drug) twice daily and oral corticosteroids, with a maximum daily dose of 400 mg.

Key results

The full results of the study were not published. Only limited results on side effects were published online. Six out of nine volunteers (66.67%) in the omalizumab group and one out of five volunteers (20%) in the placebo group reported one or more serious side effects.

Due to the lack of evidence, we are not able to make recommendations either in favour of, or against the use of, anti-IgE (omalizumab) therapy in people with cystic fibrosis and allergic bronchopulmonary aspergillosis. More research into this treatment is needed.