Omalizumab in Asthma: An Update on Recent Developments

Inhalation therapy in the next decade: Determinants of adherence to treatment in asthma and COPD

“…In these patients, allergen-immunotherapy may be a new option, considering that a recent study has demonstrated the efficacy of two dose regimen of well standardized allergen extracts of house dust mite on the prevention of asthma exacerbations induced by a progressive reduction in the ICS dose [34]. Similarly, in severe allergic asthmatics with pre-specified levels of serum IgE and sensitization to perennial allergens, the monoclonal antibody omalizumab is strongly recommended, due to the high efficacy in improving asthma control and reducing the frequency of asthma exacerbations [35].…”

Omalizumab reduces bronchial mucosal IgE and improves lung function in non-atopic asthma

“…This has generated intense interest in identifying "phenotypes" or "endotypes" of asthma. In the case of omalizumab, the prima facie effect of which is to prevent, and possibly reverse binding of IgE to its high-and low-affinity receptors 5,6 , the tacit assumption has been that it improves asthma stability fundamentally by reducing or abolishing mast cell and basophil activation by cross-linking of surface-bound allergen-specific IgE by allergen in suitably sensitised, "atopic" patients. Consequently, key clinical trials investigating its efficacy, such the INNOVATE study 7 have been limited to atopic asthmatics while its marketing authorisation restricts its use to patients with "convincing IgE-mediated asthma".…”

Anti-IgE treatment, airway inflammation and remodelling in severe allergic asthma: current knowledge and future perspectives

“…1). Although the exact underlying mechanisms of airway remodelling still elude us, the existence of chronic persistent inflammation, involving longstanding exposure of the airways to a variety of environmental agents, cells and mediators, is generally considered a prerequisite [7][8][9], and IgE is central to the initiation and persistence of this inflammation [2,10]. Therapeutic agents with the potential to block the allergic cascade at an early stage, such as omalizumab, may potentially also attenuate airway remodelling, a possibility also supported by evidence suggesting that long-term anti-IgE treatment remains effective long after it has been discontinued [11][12][13].…”