Impacto do omalizumabe na asma grave em pacientes pediátricos, adolescentes e adultos jovens no sul do Brasil: estudo retrospectivo
Impact of omalizumab on severe asthma in pediatric patients, adolescents, and young adults in southern Brazil: a retrospective study
Jessica Cunha de Almeida, Amaralina Joyce Macedo de Andrade, Lidiane Aita Boemo, Tatiana Pegoraro Postal, Carolina Teló Gehlen Branco, Daniela Albarello dos Santos, Arnaldo Carlos Porto
Resumo
Introdução: A asma grave na população pediátrica apresenta importante impacto clínico e econômico. O omalizumabe é uma opção de tratamento para pacientes com asma grave não controlada, porém estudos com crianças e adolescentes ainda são limitados. Este estudo objetivou descrever o perfil clínico e imunológico de pacientes com asma grave em uso de omalizumabe e avaliar resposta terapêutica. Métodos: Estudo observacional retrospectivo incluindo 25 pacientes com idade de 6 a 19 anos que iniciaram tratamento com omalizumabe para asma entre janeiro de 2020 e junho de 2025, em um ambulatório de alergologia e imunologia pediátrica, comparando dados antes do tratamento e após 16 e 52 semanas, incluindo biomarcadores da inflamação tipo 2, Asthma Control Test (ACT), utilização de serviços de saúde relacionados à asma e quantidade de classes de medicamentos empregadas. Resultados: Todos os pacientes apresentavam fenótipo atópico, com frequência elevada de sensibilização à poeira doméstica e a pólens gramíneas. Não houve diferença estatisticamente significativa nos níveis de IgE total e contagem de eosinófilos durante o acompanhamento. Houve melhora do controle da asma, com aumento da proporção de pacientes com ACT ≥ 20, além de redução significativa dos atendimentos em prontoatendimento, da necessidade de oxigenoterapia, das internações hospitalares e do número de classes de medicamentos utilizadas. Conclusão: A terapia com omalizumabe associou-se à melhora clínica da asma, redução dos serviços de saúde relacionados às exacerbações e simplificação do tratamento de manutenção em pacientes pediátricos com asma grave.
Palavras-chave
Abstract
Introduction: Severe asthma in the pediatric population is associated with significant clinical and economic burden. Omalizumab is a therapeutic option for patients with uncontrolled severe asthma; however, studies involving children and adolescents remain limited. This study aimed to describe the clinical and immunological profile of patients with severe asthma receiving omalizumab and to evaluate their therapeutic response. Methods: This retrospective observational study included 25 patients aged 6 to 19 years who initiated omalizumab treatment for asthma between January 2020 and June 2025 at a Pediatric Allergy and Immunology outpatient clinic. Data collected before treatment and after 16 and 52 weeks were compared, including type 2 inflammatory biomarkers, Asthma Control Test (ACT) scores, asthma-related healthcare utilization, and the number of maintenance medication classes. Results: All patients exhibited an atopic phenotype, with a high frequency of sensitization to house dust and grass pollens. No statistically significant differences were observed in total IgE levels or peripheral eosinophil counts during follow-up. Asthma control improved over time, with an increased proportion of patients achieving an ACT score ≥20, accompanied by significant reductions in emergency department visits, the need for oxygen therapy, hospitalizations, and the number of maintenance medication classes. Conclusion: Omalizumab therapy was associated with improved asthma control, reduced healthcare utilization related to asthma exacerbations, and simplification of maintenance therapy in pediatric patients with severe asthma.
Keywords
Referências
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Submetido em:
23/03/2026
Aceito em:
22/08/2026
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