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Medline ® Abstract for Reference 18

of 'Overview of skin testing for allergic disease'

Immunological and clinical changes in allergic asthmatics following treatment with omalizumab.
Noga O, Hanf G, Kunkel G
Int Arch Allergy Immunol. 2003;131(1):46.
IgE plays a key role in allergic asthma. We investigated whether omalizumab treatment of patients with moderate to severe allergic asthma leads to changes in inflammatory mediators and clinical symptoms. This sub-study was conducted on 35 patients with a positive skin prick test (SPT) requiring daily administration of beclomethasone dipropionate (500-1,000 microg), who participated in a multicentre, randomised, double-blind, placebo-controlled study. Omalizumab or placebo was administered at 0.016 mg/kg/IgE every 4 weeks. Patients recorded peak expiratory flow, asthma symptom score and beta(2)-agonist use in daily diaries and spirometry was performed at each visit. beta(2)-Agonist use and SPT wheal reaction decreased significantly (p<0.05). Circulating levels of IL-5, IL-6, IL-8, IL-10, IL-13 and s-ICAM were measured before and after 16 weeks of treatment. IL-13 and s-ICAM were measured before and after 16 weeks of treatment. IL-13 decreased significantly (p<0.01). IL-5 and IL-8 decreased in the omalizumab group compared to baseline. The other circulating mediators did not demonstrate any changes. Histamine release was significantly reduced (p<0.01). Airway resistance (p<0.05) and the provocative concentration inducing a 20% decrease in FEV(1) (p<0.05) were measured before, after 16 weeks, and 3 months after completion of treatment. Both parameters decreased significantly (p<0.05). Peripheral eosinophil count decreased significantly compared to placebo (p<0.01). These findings suggest that omalizumab has potential as a novel treatment for allergic asthma.
Allergy and Asthma Clinic, Charité, Humboldt University, Berlin, Germany. oliver.nago@charite.de