Omalizumab in patients with severe asthma and persistent sputum eosinophilia

 
Letter to the editor       Open Access
 
Manali MukherjeeMelanie KjarsgaardKatherine RadfordChynna HuangRichard LeighDelbert R. DorscheidCatherine LemiereLouis-Philippe BouletSusan WasermanJames Martin and Parameswaran Nair Email authorView ORCID ID profile

Abstract

Omalizumab, a recombinant humanized monoclonal antibody targeting the IgE molecule, is the first biologic approved for moderate-to-severe allergic asthmatics, who remain uncontrolled despite high dose inhaled corticosteroid and bronchodilators. Steroid-sparing effect of omalizumab has not been demonstrated in asthmatics with persistent airway eosinophilia in a randomised controlled trial till date. From this double-blind, placebo-controlled, multi-centred, randomized parallel group design, we report that omalizumab is possibly inadequate to control sputum eosinophilia, and therefore may not have a steroid-sparing effect, especially in those maintained on oral corticosteroids daily. This needs to be confirmed or refuted in a larger trial, which may be a challenge with respect to recruitment, since there are currently three additional biologics available to prescribe.

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Editor: Juan C. Ivancevich, MD

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