SPECIAL COMMENTARYFour-year follow-up in children with moderate/severe uncontrolled asthma after withdrawal of a 1-year omalizumab treatmentBaena-Cagnani, Carlos E.; Teijeiro, Alvaro; Canonica, G. Walter Author Information aResearch Centre for Respiratory Medicine, Faculty of Medicine, Catholic University of Córdoba, Córdoba bLIBRA Foundation, Buenos Aires cRespiratory Centre, Pediatric Hospital, Córdoba, Argentina dAllergy & Respiratory Disease Clinic, University of Genoa, IRCCS AOU S. Martino, Genova, Italy *Deceased. Correspondence to G. Walter Canonica, Allergy & Respiratory Disease Clinic, University of Genoa, IRCCS AOU, S. Martino, 16132 Genova, Italy. E-mail: [email protected] Current Opinion in Allergy and Clinical Immunology: June 2015 - Volume 15 - Issue 3 - p 267-271 doi: 10.1097/ACI.0000000000000161 Buy Metrics Abstract 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. Recent findings 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, children 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. Summary 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. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.