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Four-year follow-up in children with moderate/severe uncontrolled asthma after withdrawal of a 1-year omalizumab treatment

Baena-Cagnani, Carlos E.; Teijeiro, Alvaro; Canonica, G. Walter

Current Opinion in Allergy and Clinical Immunology: June 2015 - Volume 15 - Issue 3 - p 267–271
doi: 10.1097/ACI.0000000000000161
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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.

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: canonica@unige.it

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