[Omalizumab: What have we learned after ten years of prescription?]

Abstract

Introduction: Omalizumab, an anti-immunoglobulin E monoclonal antibody, has now been used for ten years as an add-on therapy for severe adult atopic asthma, poorly controlled by high-doses inhaled steroids and long-acting beta-agonists.

Background: This innovative therapy has been the first biotherapy used on a large scale in severe asthma. It has shown clinical benefits, especially in the prevention of severe exacerbation, with a satisfactory safety profile. Despite its cost, it is an interesting alternative to continuous oral steroids, which cause more long-term side effects.

Perspectives: After ten-years of prescription of omalizumab, we review here the mechanism of action, the benefits, the main side effects, the cost-effectiveness and also the alternative indications of this interesting molecule. We also consider the practicalities of using omalizumab, particularly the importance a rigorous assessment of its efficacy after 16 weeks of treatment, and possible future therapeutic indications.

Conclusion: Omalizumab has proven its efficacy in large randomized studies but also in real life practice in severe allergic asthma.

Keywords: Asthma; Asthme; Atopie; Atopy; Biotherapy; Biothérapie; Immunoglobulin E; Immunoglobuline E; Omalizumab.