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Omalizumab Effective In Treating Inadequately Controlled Allergic Asthma

May 6, 2011

Patients with severe allergic asthma that is inadequately controlled with the standard of care had improved symptoms and decreased flare-ups with injections of an antibody drug called omalizumab, according to experts at Baylor College of Medicine in a paper that appears in the current issue of Annals of Internal Medicine.

“Many patients suffering from asthma who are being treated with the recommended inhaled corticosteroids and long-acting beta agonists continue to have asthma symptoms,” said Dr. Nicola Hanania, associate professor of medicine-pulmonary at BCM and first author of the paper.

Hanania and his colleagues sought to find out whether adding omalizumab injections would improve asthma control in patients with allergic asthma, which is asthma that is triggered by allergies.

Neutralizes antibody in blood

“Omalizumab works through a different mechanism than other existing medications,” said Hanania. “It targets an antibody in the blood, IGE, which is a problem for patients who have allergic asthma. This drug neutralizes the antibody in the blood and prevents it from attaching to inflammatory cells and releasing chemicals that cause wheezing and other symptoms of asthma.”

The study looked at 850 patients with allergic asthma who used the standard of care but still had asthma symptoms and a history of exacerbation. They were either treated with a placebo or omalizumab for 48 weeks.

Those treated with omalizumab in addition to the inhaled corticosteroid and long-acting beta-agonist combination showed significant decrease in asthma exacerbation rates and improvement in asthma control.

Add-on to standard treatment

“This is an important treatment option for this small subgroup of patients who still suffer from asthma symptoms despite standard treatment,” said Hanania. “This is an add-on to their standard treatment, not a replacement for it.”

Within the group that received omalizumab, there were three subgroups. The first group received the standard of care, the inhaled corticosteroids and long-acting beta agonists, and omalizumab. The second had the standard of care plus one additional asthma controller medication and the omalizumab, and the final group received the standard of care, an oral corticosteroid and the omalizumab.

Findings

Researchers found that the first two groups had significant responses to the treatment, but the third group that included oral corticosteroids did not have results that were as significant. This could have been because the group was smaller in size or because those who are dependent on steroids may not respond to other therapies.

The study also showed that treatment with FDA-approved omalizumab was well tolerated.

Others who took part in the study included Dr. Oral Alpan of O & O Alpan, LLC; Dr. Daniel L. Hamilos of Massachusetts General Hospital; Dr. John J. Condemi of Allergy Asthma Immunology of Rochester; Dr. Irmarie Reyes-Rivera, Dr. Jin Zhu, Dr. Karin E. Rosen, Dr. Mark D. Eisner and Dr. Dennis A. Wong of Genentech; and Dr. William Busse of the University of Wisconsin School of Medicine and Public Health.

Funding for this study was provided by Genentech and Novartis Pharmaceuticals.

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