title: Omalizumab in asthma: an update on recent developments.
abstract: IgE is central to the pathophysiology of allergic asthma. Omalizumab, a humanized anti-IgE mAb, specifically binds free IgE and interrupts the allergic cascade by preventing binding of IgE with its high-affinity FcεRI receptors on mast cells, antigen-presenting cells, and other inflammatory cells. The clinical efficacy of omalizumab has been well documented in a number of clinical trials that involve adults, adolescents, and children with moderate-to-severe and severe allergic asthma. In these studies, omalizumab reduced exacerbations, asthma symptoms, inhaled corticosteroid and rescue medication use, and improved quality of life relative to placebo or best standard of care. Similar benefits have been reported in observational studies in "real-world" populations of patients. Results from recent pooled data from randomized clinical trials and from a large prospective cohort study provide reassurance about the long-term safety of omalizumab. Omalizumab dosing is individualized according to body weight and serum-IgE level, and recent adjustments to the dosing algorithm in Europe have enabled more patients to be eligible for treatment. Ongoing and future research is investigating the optimal duration of therapy, accurate predictors of response to treatment, and efficacy in nonatopic asthma as well as other IgE-mediated conditions.
authors.affiliation: Service de Pneumologie University Paris-Sud, Inserm U999, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. Electronic address: marc.humbert@bct.aphp.fr.
authors.forename: Marc
authors.initials: M
authors.lastname: Humbert
authors.affiliation: Department of Medicine, University of Wisconsin Medical School, Madison, Wis.
authors.forename: William
authors.initials: W
authors.lastname: Busse
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Nicola A
authors.initials: NA
authors.lastname: Hanania
authors.affiliation: Advanced Quantitative Sciences, Novartis Pharma AG, Basel, Switzerland.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Lowe
authors.affiliation: Novartis Pharmaceuticals UK Limited, Clinical Research, Horsham, West Sussex, UK.
authors.forename: Janice
authors.initials: J
authors.lastname: Canvin
authors.affiliation: Translational Medicine, Respiratory Profiling, Novartis Pharma AG, Basel, Switzerland.
authors.forename: Veit J
authors.initials: VJ
authors.lastname: Erpenbeck
authors.affiliation: University of Southampton, Faculty of Medicine, Southampton General Hospital, Southampton, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Holgate
mesh_terms: D018926:Anti-Allergic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D000069444:Omalizumab
chemical_list: D018926:Anti-Allergic Agents; D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab; D007073:Immunoglobulin E
keywords: Allergic asthma; Anti-IgE; Exacerbations; Omalizumab