Purpose of review
Allergic asthma, which is the most frequent asthma phenotype, is mainly a chronic inflammatory disease characterized by elevated serum IgE
levels and specific-IgE
against common allergens. A significant group of asthmatic children
have uncontrolled moderate/severe symptoms despite the use of medium/high doses of inhaled corticosteroids (ICS) in combination with another controller. Asthma guidelines suggest omalizumab
as an add-on therapy in these children
and recent evidence has shown the efficacy and safety of this mAb against IgE
Asthma cannot be cured and current available treatments are unable to modify the natural course of the disease. Recent studies have shown positive effects of omalizumab
in reducing airway inflammation and remodelling
. Herein, a 4-year follow-up of a group of children
with moderate/severe uncontrolled asthma taking part in a randomized double blind placebo control with omalizumab
is shown. After discontinuation of anti-IgE
were followed up for 4 years. During the first 3 years of follow-up, they were completely free of asthma symptoms without any need of ICS or rescue medication.
The new evidence published and the clinical observation described herein generate the hypothesis that treatment with omalizumab
could potentially modify the natural course of asthma. However, further studies are needed.