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Omalizumab effectively treated adults with severe refractory asthma

Omalizumab was effective in treating adults with severe refractory asthma for up to 48 weeks, possibly exerting anti-inflammatory effects on small airways and reversing airway remodeling, according to recent study results.

Researchers in Japan conducted a prospective, observational study of 31 adults (mean age, 55 years; 21 women) with severe refractory asthma despite using multiple therapies including high-dose inhaled corticosteroids (1,432 ± 581 mcg per day fluticasone propionate equivalent). Variables assessed at baseline and after 24 and 48 weeks treatment with omalizumab included Asthma Quality of Life Questionnaire, asthma exacerbations, exhaled nitric oxide, pulmonary function, methacholine airway responsiveness, induced sputum and chest computed tomogram. Body weight and baseline total serum IgE levels were used to determine subcutaneous dosing of omalizumab every 2 to 4 weeks.

In 26 patients who completed 48 weeks of treatment, Asthma Quality of Life Questionnaire scores and peak expiratory flow values displayed significant and continuous improvement (P<.001 for all comparisons).

“Unscheduled physician visits, asthma exacerbations requiring systemic corticosteroids, fractional exhaled nitric oxide at 50 mL per second and alveolar nitric oxide levels, sputum eosinophil proportions and airway-wall thickness as assessed by computed tomography significantly decreased at 48 weeks (P<.05 for all comparisons),” the researchers wrote.

“Omalizumab is effective for adults with severe refractory asthma and … it can reverse airway remodeling,” the researchers concluded. “Despite several limitations … this study may provide new and clinically important information on omalizumab treatment for patients with the most severe asthma.”

Disclosure: Researcher Hisako Matsumoto, MD, PhD, received remuneration from lectures sponsored by Novartis.