Update on optimal use of omalizumab in management of asthma

Girolamo Pelaia¹, Luca Gallelli¹, Teresa Renda¹, Pasquale Romeo¹, Maria Teresa Busceti¹, Rosa Daniela Grembiale¹, Rosario Maselli¹, Serafino Antonio Marsico², Alessandro Vatrella^3
1Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Catanzaro; ²Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Naples; ³Department of Respiratory Medicine, University of Salerno, Salerno, Italy

Abstract: Omalizumab is a humanized monoclonal anti-IgE antibody recently approved for the treatment of severe allergic asthma. This drug inhibits allergic responses by binding to serum IgE, thus preventing interaction with cellular IgE receptors. Omalizumab is also capable of downregulating the expression of high affinity IgE receptors on inflammatory cells, as well as the numbers of eosinophils in both blood and induced sputum. The clinical effects of omalizumab include improvements in respiratory symptoms and quality of life, paralleled by a reduction of asthma exacerbations, emergency room visits, and use of systemic corticosteroids and rescue bronchodilators. Omalizumab is relatively well-tolerated, and only rarely induces anaphylactic reactions. Therefore, this drug represents a valid option as add-on therapy for patients with severe persistent allergic asthma inadequately controlled by high doses of standard inhaled treatments.

Keywords: omalizumab, anti-IgE, severe asthma