Omalizumab for pediatric asthma.
BACKGROUND
Omalizumab is of proven efficacy in the treatment of severe allergic bronchial asthma and works through inhibiting the activity of IgE and the allergic immune mechanism IgE mediates. It has been demonstrated to be efficacious in children with asthma but is not approved by the FDA for use in children below 12 years of age.


METHODS
Omalizumab is a 95% humanized monoclonal antibody that binds to circulating IgE at the same site on the Fc domain as the high-affinity IgE receptor, FcϵRI. This blocks the interaction between IgE and mast cells and basophils, thereby preventing the release of inflammatory mediators that cause allergic signs and symptoms.


RESULTS
From the review of the literatures and statements from the FDA, Genentec and Novartis, the reader will gain a better appreciation of the value of omalizumab in treatment of severe asthma and the current status of its reported side effects.


CONCLUSIONS
Omalizumab is of proven efficacy in adults and children with severe asthma and allows a markedly reduced dependence on oral and inhaled corticosteroids and decreased hospitalizations. A potential mechanism of omalizumab's effect on thrombus formation and cardiovascular effect is postulated.
Division of Asthma, Creighton University Medical Center, 601 N, 30th ST, Suite 3M100, Omaha, NE 68131, USA. rtownley@creighton.edu
Robert G
RG
Townley
Swati
S
Agrawal
Kiran
K
Sapkota
D000293:Adolescent; D000818:Animals; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000737:chemistry / Q000191:economics / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000737:chemistry / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001249:Asthma / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D002648:Child; D015267:Churg-Strauss Syndrome / Q000453:epidemiology / Q000209:etiology; D003131:Combined Modality Therapy; D004198:Disease Susceptibility; D004306:Dose-Response Relationship, Immunologic; D004311:Double-Blind Method; D005260:Female; D006373:Helminthiasis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007073:Immunoglobulin E / Q000187:drug effects / Q000276:immunology*; D007141:Immunoglobulin Fc Fragments / Q000187:drug effects*; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008252:Macaca fascicularis; D008297:Male; D051379:Mice; D015394:Molecular Structure; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology; D000069444:Omalizumab; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D017455:Receptors, IgE / Q000276:immunology*
D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007141:Immunoglobulin Fc Fragments; D017455:Receptors, IgE; D000069444:Omalizumab; D007073:Immunoglobulin E