Abstracts: Poster Sessions / Ann Allergy Asthma Immunol 119 (2017) S17eS96
nasal polyps, regardless of their steroid status (table 1). At week 48, all patient groups improved in excess of the MID threshold of 0.4 units in MiniRQLQ (mean (SD): -0.87 (1.52), -1.23 (1.13), -0.99 (1.06), -1.02 (1.30). Adverse events were consistent with the known safety profile of omalizumab. Conclusion: Patients with asthma with and without comorbid nasal polyps experience clinically significant and meaningful improvements in MiniRQLQ scores after initiation on omalizumab regardless of baseline steroid burden.
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P432 USE OF HOME BIPAP FOR REFRACTORY VOCAL CORD DYSFUNCTION (VCD) M. Wahidi*1, W. Lee1, D. Khan2, 1. Dallas, TX; 2. Grapevine, TX. Introduction: VCD may be mistaken for anaphylaxis. Treatment of VCD is typically with speech therapy. Reassurance/supportive care may be used acutely for mild cases but more severe cases have been treated with heliox or CPAP. Methods: We present a patient with refractory VCD who responded to home BiPAP therapy. Results: A 33 yo woman presented with a history of recurrent “anaphylaxis”. Within 6 months she had 7 severe episodes, 5 resulting in intubation. Episodes began with chest flushing, and pruritus and within minutes she developed severe dyspnea with chest/throat tightness, and stridor. She also reported more frequent minor episodes that did not result in urgent care visits. No triggers were identified including foods, drugs, exercise, or insect stings. Review of prior medical records revealed no documented rash or hypoxia, but occasional mild hypercarbia on ABGs. Duration of intubation ranged between 12-24 hours and laryngoscopy after intubation showed no evidence of laryngeal edema. Serum tryptase was normal. Due to concerns for VCD, speech therapy was initiated with improvement in mild episodes but she continued to go the ED and was hospitalized for more severe episodes. Due to recurrent admissions despite speech therapy and lack of availability of heliox at local EDs, AUTO BiPAP was recommended (min 5, max 14, PS 5). Since using home BiPAP, she has not had any further hospitalizations or intubations for her VCD. Conclusion: For severe refractory cases of VCD, use of home BiPAP may be considered to potentially eliminate hospitalizations and intubations.
P431 NOVEL PHOTO-ELECTROCHEMICAL OXIDATION AIRPURIFIICATION TECHNOLOGY REDUCES NASAL AND OCULAR ALLERGY SYMPTOMS J. Wong1, N. Rao*1, S. Liggett2, Y. Goswami2, A. Kumar2, 1. San Francisco, CA; 2. Tampa, FL. Background: Photo-electrochemical oxidation (PECO) is a new air purification technology developed to reduce circulating indoor allergens. PECO removes particles as small as 30 nanometers with the destruction of organic matter otherwise not trapped by a traditional filter and removes volatile organic compounds. We hypothesized that with daily use, the device would reduce user nasal and ocular allergy total symptom scores within 4 weeks. Methods: The study was performed among 46 individuals with self-reported allergies. Self-reported total symptom scores (TSS) were calculated at baseline and weekly for 4 weeks following initiation of continuous use of the system. TSS was the sum of total nasal symptom scores (TNSS) and total ocular symptom scores (TOSS) for the week. Results: There was a statistically significant change in overall TSS from baseline to four weeks (10.1 at baseline and 4.35 post-intervention) resulting in a mean difference of 5.75 (95% CI 4.32 to 7.18; p<0.0001). There was a statistically significant change in TNSS score from baseline to four weeks (6.3 at baseline and 3.04 postintervention) resulting in a mean difference of 3.26 (95% CI 2.33 to 3.19; p<0.0001). There was a statistically significant change in TOSS score from baseline to four weeks (3.82 at baseline and 1.3 postintervention) resulting in a mean difference of 2.52 (95% CI 1.74 to 3.3; p<0.0001). Conclusions: With the use of PECO air purification technology, TSS, TNSS and TOSS scores decreased significantly. These improvements were consistent over the 4-week course of device use.
P433 EFFICACY AND SAFETY OF ONCE-DAILY AND TWICEDAILY OLOPATADINE/MOMETASONE NASAL SPRAY TREATMENT IN SEASONAL ALLERGIC RHINITIS C. Andrews*1, D. Mohar2, P. Agarwal3, Y. Salhi4, S. Tantry5, 1. San Antonio, TX; 2. Kerrville, TX; 3. Navi Mumbai, India; 4. Middlesex, United Kingdom; 5. Mahwah, NJ. Introduction: In patients with allergic rhinitis (AR), intranasal combination treatment with an antihistamine and a corticosteroid may provide improved symptom relief over monotherapy treatment. GSP301 nasal spray (NS) is a fixed-dose-combination of the antihistamine olopatadine hydrochloride and the corticosteroid mometasone furoate. Efficacy and safety of GSP301 once-daily (QD) or twice-daily (BID) were evaluated in this seasonal AR (SAR) study. Methods: In this randomized, double-blind, parallel-group study, patients (12 years) with SAR were equally randomized to GSP301 BID (olopatadine 665mg/mometasone 25mg), GSP301 QD (olopatadine 665mg/mometasone 50mg), olopatadine monotherapy (665mg BID or QD), mometasone monotherapy (25mg BID or 50mg QD), or placebo for 14 days. The primary endpointdmean change from baseline in AM and PM reflective total nasal symptom score (rTNSS)dwas analyzed using ANCOVA. Adverse events (AEs) were also assessed. Results: A total of 1,111 patients were randomized. GSP301 BID or QD treatment significantly improved rTNSS scores vs placebo (least square means difference [95% CI] GSP301 BID: -1.17 [-1.73, -0.61]; GSP301 QD: -1.11 [-1.67, 0.55]; P<0.0001, both). GSP301 BID treatment also showed significant improvement vs olopatadine ( 0.49 [-0.98, -0.00]; P¼0.049) and mometasone (-0.71 [-1.20, -0.22]; P¼0.004). The percentages of patients reporting treatment-emergent AEs were 10.8%, 9.5%, and 8.2%, with GSP301 BID, GSP301 QD, and placebo.