Deflazacort: a possible alternative in corticosteroid allergy.

improvement in nasal symptoms (congestion and hydrorrhea, and, to a lesser extent, hyposmia); 2 months later she had also achieved better asthma control (no further need for rescue bronchodilator use and no asthma symptoms, leading to the withdrawal of inhaled corticosteroids and long-acting ß 2 agonists, and a signifi cant improvement of FEV 1 up to 90% of predicted). After 16 weeks of treatment with omalizumab, the Asthma Control Test score had risen from 11 to 25 points, and the asthma-related quality of life questionnaire (AQLQ) revealed a score of 6.8. Before starting the anti-IgE therapy, she had a severely impaired quality of life, with an AQLQ of 3.68 (>1.5 points improvement). In September 2009, a specifi c bronchial challenge with lysine-acetylsalicylate yielded a negative result, and in October 2009, an oral challenge with aspirin with a cumulative dose of 750 mg was also negative. In the follow-up visit in December 2009, a certain degree of hyposmia persisted, despite continuous therapy with intranasal corticosteroids, and the methacholine test was still positive (PC 20 , 1.84 mg/mL). The patient, however, had no asthma symptoms under treatment with montelukast and omalizumab only. She had also tolerated ibuprofen 600 mg perfectly on several occasions. Omalizumab could prove effective in the treatment of AERD, as demonstrated by the experience of our patient, who not only succeeded in controlling the disease and signifi cantly improving her quality of life but is also now capable of tolerating aspirin and other COX-1 inhibitors. Further studies are required in order to confi rm the effectiveness of omalizumab in patients with AERD.