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, 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.
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.
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
Correspondence to G. Walter Canonica, Allergy & Respiratory Disease Clinic, University of Genoa, IRCCS AOU, S. Martino, 16132 Genova, Italy. E-mail: firstname.lastname@example.org