Omalizumab effectively protects against early and late allergic responses in asthma after 4 weeks

Allergy. 2017 Dec;72(12):1912-1915. doi: 10.1111/all.13217. Epub 2017 Jun 28.

Abstract

Background: Omalizumab is licensed for therapy in severe allergic asthma with an effect demonstrated after 8 weeks or longer treatment. As new applications for omalizumab demand precise knowledge of the onset of effects, the objective of this study was to determine the time course of the early (EAR) and late allergic reaction (LAR).

Materials and methods: Ten patients (IgE>300 IU/mL and <700 IU/mL) with a significant response to allergen challenge were treated with omalizumab according to the approved dosing table. Bronchial allergen provocations (BAP) were repeated at weeks 1, 2, 4, and 8.

Results: EAR was significantly reduced after 4 weeks (ΔFEV1 28% vs 11%; P<.001), eNO (86 vs 53 ppb; P<.05) and basophil activation after 2 weeks (CD63 expression 79% vs 32%, P<.05) and LAR already after 1 week (ΔFEV1 26% vs 13%, P<.05).

Conclusion: These results demonstrate the onset of protective effects earlier than previously determined, potentially improving seasonal utilization and combination with immunotherapy.

Keywords: Omalizumab; allergen challenge; early allergic reaction; exhaled NO; late allergic reaction.

MeSH terms

  • Adult
  • Allergens / immunology
  • Anti-Asthmatic Agents / pharmacology
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • Asthma / immunology*
  • Basophils / immunology
  • Basophils / metabolism
  • Biomarkers
  • Female
  • Humans
  • Hypersensitivity / immunology*
  • Hypersensitivity / prevention & control*
  • Male
  • Nitric Oxide / metabolism
  • Omalizumab / pharmacology
  • Omalizumab / therapeutic use*
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Allergens
  • Anti-Asthmatic Agents
  • Biomarkers
  • Omalizumab
  • Nitric Oxide