Researchers have found that Xolair (omalizumab) reduced increases in seasonal asthma attacks in children and young adults with allergic asthma and reduced the need for controller medication when used in concert with National Institutes of Health-based treatment guidelines. The findings have been published in the New England Journal of Medicine.
“The increased number of asthma attacks we typically see in the fall and spring nearly was eliminated in the children and adolescents who received the drug,” said Rebecca Gruchalla, MD, study co-author and chief of allergy and immunology at UT Southwestern Medical Center. “While these children typically are exposed to multiple allergens that are difficult if not impossible to control, their asthma improved dramatically when we added omalizumab to therapy. Those who received the drug experienced 25% fewer days with symptoms and a 30% reduction in asthma attacks.”
Omalizumab binds to and inactivates IgE antibodies, which are the fuel in the immune system that perpetuates the asthmatic reaction. This therapy is already being used successfully in adults and adolescents who have allergic asthma.
The study was conducted by the Inner-City Asthma Consortium (ICAC), a 5-year, $56 million NIH-sponsored project to investigate novel treatments and causes of asthma in urban children. The study involved 419 children and young adults between ages 6 and 20 with persistent moderate-to-severe allergic asthma. Of the participants, 60% were African-American; Hispanics accounted for another 37%. More than half were 6- and 11-year-old males.
The participants, from eight cities across the United States, received care based on NIH guidelines for 60 weeks. Each participant randomly was assigned to receive either injected omalizumab or a placebo every two to four weeks. Their regular asthma medications were periodically adjusted as needed.
Interestingly, the researchers also found that study participants who had positive skin tests for cockroach allergy and who had high levels of cockroach allergen in their residences showed the best response to omalizumab. Exposure to these allergens has been shown previously to be an important cause of asthma-related illness and hospitalization in children.
“Since ridding inner-city environments of indoor allergens, including cockroach allergen, is a monumental, if not impossible task, the use of an agent such as omalizumab may circumvent the need to eradicate these allergens,” said Gruchalla.
Source: UT Southwestern Medical Center