title: Efficacy of omalizumab in asthmatic patients with IgE levels above 700 IU/mL: a retrospective study.
abstract: BACKGROUND
  Omalizumab is approved for patients with poorly controlled asthma with serum IgE levels between 30 and 700 IU/mL and positive test results for perennial allergens. Its efficacy in patients with IgE levels greater than 700 IU/mL is unclear.
  
  
  OBJECTIVE
  To evaluate the response of asthmatic patients treated with omalizumab with IgE levels greater than 700 IU/mL.
  
  
  METHODS
  Asthmatic patients treated with omalizumab for 6 months or longer with elevated IgE levels were evaluated retrospectively. Emergency department (ED) visits, hospitalizations, change in forced expiratory volume in 1 second, corticosteroid bursts, and Asthma Control Test (ACT) scores were recorded for a period of 6 months before and after treatment.
  
  
  RESULTS
  Twenty-six patients with an IgE level greater than 700 IU/mL (group 1) were matched by age, sex, and severity of asthma to patients with an IgE of 30 to 700 IU/mL (group 2). The mean numbers of ED visits before and after treatment were 0.96 vs 0.23 (P = .008) in group 1 and 0.65 vs 015 (P = .02) in group 2. Both group 1 and group 2 had an improvement in asthma control based on the mean ACT score before and after treatment (15.6 vs 18.9 [P = .02] and 15.4 vs 19 [P = .006], respectively). There was also a significant reduction in the frequency of systemic corticosteroid use during the 6 months before and after treatment (2.58 vs 0.96 [P < .001] and 2.62 vs 1.23 [P < .001] systemic steroid treatments, respectively).
  
  
  CONCLUSIONS
  Omalizumab was as effective in reducing ED visits, controlling asthma symptoms, and reducing the need for systemic corticosteroids in patients with IgE levels greater than 700 IU/mL compared with patients with levels of 30 to 700 IU/mL.
authors.affiliation: Division of Pulmonary Diseases and Critical Care, University of Texas Health Science Center at San Antonio, TX, USA. masellicacer@uthscsa.edu
authors.forename: Diego Jose
authors.initials: DJ
authors.lastname: Maselli
authors.forename: Harjinder
authors.initials: H
authors.lastname: Singh
authors.forename: Joseph
authors.initials: J
authors.lastname: Diaz
authors.forename: Jay I
authors.initials: JI
authors.lastname: Peters
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006760:Hospitalization; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab; D007073:Immunoglobulin E