Recent Advances in Patient Treatment and Care (Track)

Omalizumab effect in non-allergic asthma patients

Christian D. Ribas
Department de Medicina, Pulmonary Service Hospital De Sabadell, Corporacio Parc Tauli. Parc Tauli, Spain

Abstract:

Until November 2006, there were no other admitted treatments for severe asthma patients than oral corticosteroids (1). Several immunosuppressors had been tested but despite the favourable results of some studies (2, 3), they were considered inconclusive and none international guideline advise their use. Until 2006, there was no alternative to oral corticosteroids for patients classified in the highest treatment step. Then, a new drug, omalizumab, a murine IgE antibody blocking agent was marketed (4). Although omalizumab had been tested in patients with allergic asthma receiving inhaled corticosteroids, in November 2006 the GINA (Global Initiative for Asthma Treatment) included omalizumab in the highest treatment step, that is as an alternative or as add-on therapy for uncontrolled patients requiring oral corticosteroids (4). Since then, some experience has appeared in the literature showing the oral corticosteroid sparing effect of omalizumab in allergic asthmatic patients (5, 6). The drug has also been prescribed in off-label situations but there is no wide experience on omalizumab effectiveness in off-label prescriptions. Since asthma is a very prevalent disease it made sense to us to explore the possible benefits that omalizumab could offer to non-allergic asthma patients but with blood IgE concentrations above 30 IU/mL. The talk will review the published literature as well as the experience of the author in this field.

References:

[1]        Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. NHLBI/WHO workshop report. National Institutes of Health, National Heart, Lung and Blood Institute. NIH publication number 95-3659. http://www.ginasthma.com

[2]        Comet R, Domingo Ch, Larrosa M, Morón A,Rué M, Amengual M.J., Marín A. Benefits of low weekly doses of methotrexate in steroid-dependent asthmatic patients. a double-blind, randomized, placebo-controlled study. Respir. Med. 2006; 100: 411-419.

[3]        Domingo Ch, Moreno A, Amengual M.J, Comet R, Luján M. Twelve years’ experience with methotrexate for GINA treatment step 5 asthma patients. Curr. Med. Res. Opin. 2008; 25: 367-374.

[4]        Domingo Ch, Pacheco A, Hinojosa M, Bosque M. The Relevance of IgE in the Pathogenesis of Allergy: The Effect of an Anti-IgE Drug in Asthma and Other Diseases. Recent Patents Inflamm. Allergy Drug Discov. 2007; 1: 151-164.

[5]        Molimard M, Buhl R, Niven T et al. Omalizumab reduces oral corticosteroid use in patients with sever allergic asthma: Real life data. Respir Med 2010; 104: 1381-1385.

[6]        Domingo Ch, Moreno A, Amengual M.J, Montón C, Suárez D, Pomares J. Omalizumab in the management of oral corticosteroid-dependent IgE-mediated asthma patients. Curr Med Res Opin 2011; 27: 1, 2011, 45–53.