Omalizumab shows benefits for asthma control

The addition of omalizumab to guideline-based therapy significantly improved asthma symptoms, decreased exacerbation of the disease and reduced the use of inhaled corticosteroids in inner-city children with asthma, according to data presented at the 2010 Annual Meeting of the American Academy of Allergy, Asthma and Immunology.

William W. Busse, MD, of the University of Wisconsin at Madison, and colleagues conducted a randomized trial to determine whether adding omalizumab (Xolair, Genentech) to the asthma treatment recommended by the National Asthma Education and Prevention Program Guidelines provides additional benefit beyond guidelines-based asthma therapy alone.

For a four-week period, the researchers recorded data on inner-city children, aged 6 to 20 years, who had persistent asthma before initiating therapy. The researchers then randomly assigned children to receive omalizumab or placebo in addition to daily treatment for 60 weeks.

Busse said omalizumab was associated with a 25% reduction in days that children experienced asthma symptoms. Although literature indicated that omalizumab would not demonstrate efficacy for three months, augmenting ongoing guideline-based therapy with omalizumab produced considerable improvement. Additionally, there was a 30% decline in hospitalizations, unscheduled hospital visits and treatment with prednisone after the addition of omalizumab to daily therapy.

Omalizumab was linked to a 15% reduction in the need for inhaled corticosteroids, according to Busse. The researchers lowered the dose of inhaled corticosteroids for children receiving omalizumab based on symptom improvement, and by the study’s conclusion, there was a differential of 109 mcg per day between the omalizumab and placebo groups. Busse also said no increase in symptoms was associated with the lower dosage of inhaled corticosteroids.

The researchers also sought to determine whether omalizumab had an effect on seasonal patterns of asthma control. Busse said supplementing guideline-based treatment with omalizumab virtually eliminated the spike in asthma symptoms typically seen in September.

No differences in rates of anaphylaxis or hypersensitivity were noted between the omalizumab and placebo groups. – by Melissa Foster

For more information:

Busse WW. #2531. Presented at: 2010 Annual Meeting of the Academy of Allergy, Asthma and Immunology; Feb. 26-March 2, 2010; New Orleans.

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