Omalizumab reduced cold symptoms among children with allergic asthma

Issue: April 2016

LOS ANGELES — Xolair significantly decreased rates of cold symptoms among inner-city children with allergic asthma, according to study findings presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.

“We previously showed that treatment with omalizumab can reduce the length of viral infection and it can also improve interferon/antiviral responses,” researcher James E. Gern, MD, from the University of Wisconsin-Madison School of Medicine and Public Health, said in a press release. “We wondered, then, if omalizumab could decrease the time that children with asthma have symptoms from upper respiratory illnesses.”

James E. Gern

In the Preventative Omalizumab or Step-up Therapy for Severe Fall Exacerbations (PROSE) study, Gern and colleagues enrolled asthmatic children aged 6-17 years (n=478) from low-income census tracts to receive guidelines-based asthma care vs. add-on fluticasone boost vs. add-on Xolair (omalizumab, Genentech).

The researchers collected cold symptoms scoring sheets weekly over the 4-month treatment period during the autumn of 2012 and 2013. Gern and colleagues identified colds as increased symptoms – including runny nose, stuffy nose, sneezing, cough and sore throat – compared to baseline. Adjusted illness rates by treatment group were calculated using an over-dispersed Poisson regression.

“This study was unique in that we had very good virology – the children who participated in the trial provided a sample of nasal mucus every week,” Gern said during a press conference. “Each of those samples was evaluated for respiratory viruses, and what we determined was that as children went back to school, the number of viruses that we found went up, and while many of these were symptomatic, some of them were not.”

According to study results, the rate of cold were among patients treated with add-on omalizumab were 27% lower than colds among patients who received guidelines-based asthma care.

The researchers noted that this reduction was observed across asthma treatment steps, with the same rate of reduction observed in children with moderate vs. severe persistent asthma. In addition, fluticasone boost had no significant impact on cold rates.

“Omalizumab had effects on exacerbations of asthma in this population – specifically, it reduced virus-induced exacerbations of asthma – and we now have evidence that it also reduces common cold symptoms, the number of viruses that children will get during a season, and specifically viral colds,” Gern said. “While omalizumab would be an extremely expensive way to treat or prevent common colds, I think that if you treat allergic inflammation, there may be secondary effects that boost interferon production and reduce viral morbidity across the board, not just exacerbations.”– by Bob Stott

Reference:

Gern J, et al. Abstract 286. Presented at: the American Academy of Allergy, Asthma & Immunology Annual Meeting; March 4-7, 2016; Los Angeles.

Disclosure: Dr. Gern reported consulting relationships with AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, MedImmune and Merck, as well as grant support from GlaxoSmithKline and Merck.