Omalizumab efficacy for asthma similar among children of different races

Key takeaways:

• 87.3% of white patients and 92.8% of Black patients had no severe exacerbations with omalizumab.
• 4% of white patients and 2.9% of Black patients had a serious adverse event with omalizumab.

Children with asthma aged 6 years to younger than 12 years had similar reductions in exacerbations with omalizumab regardless of race, according to a study published in The Journal of Allergy and Clinical Immunology: In Practice.

These findings may help incentivize improvements in access to biologic treatment, Jonathan Witonsky, MD, MAS, assistant professor in the department of pediatrics of University of California, San Francisco, and colleagues wrote.

The IA05 trial involved children with a history of exacerbations and asthma symptoms despite inhaled corticosteroid use who were treated with omalizumab (Xolair; Genentech, Novartis) in 75 mg to 375 mg doses administered subcutaneously once or twice a month.

The cohort included 325 white children (56.4%), with 113 on placebo and 212 on omalizumab; 99 Black children (17.2%), with 30 on placebo and 69 on omalizumab; and 152 children who were Asian, other race or of a race that was not reported (26.4%), with 49 on placebo and 103 on omalizumab.

Over 52 weeks, placebo-corrected rate reductions in asthma exacerbations included 36.3% among the white patients, 50.8% among the Black patients and 45.7% among the group comprising Asian patients and patients of other or unreported races.

The researchers also reported that the numbers of severe exacerbations were low regardless of race.

Compared with placebo, greater proportions of patients using omalizumab had no severe exacerbations at all regardless of race as well, including among white patients (placebo, 77% vs. omalizumab, 87.3%), Black patients (76.7% vs. 84.1%), and Asian patients and patients reporting other or no race (85.7% vs. 92.2%).

The incidence of treatment-emergent adverse events was similar between the three groups as well, the researchers found, with similarly low numbers of serious adverse events too.

Among white patients, 93.8% of the placebo group and 86.7% of the omalizumab group had a treatment-emergent adverse event. Among Black patients, 86.7% of the placebo group and 92.8% of the omalizumab group had a treatment-emergent adverse event. Among the Asian patients and patients reporting other or no race, 98% of the placebo group and 97.1% of the omalizumab group had a treatment-emergent adverse event.

Percentages of serious adverse events included 7.8% with placebo and 4% with omalizumab for the white patients, 10% with placebo and 2.9% with omalizumab for the Black patients and 8.2% with placebo and 4.9% with omalizumab among the Asian patients and patients with other or no reported race.

Despite that their study may be limited by its post-hoc nature, considering the similar reductions in asthma exacerbations with omalizumab between these groups, the researchers concluded that these findings may further incentivize current improvements in access to biologics.