Omalizumab response in patients with asthma by number and type of allergen

BackgroundThe anti–immunoglobulin E therapy, omalizumab, improves asthma control and reduces exacerbations in patients with moderate-to-severe allergic asthma. However, it has been suggested that omalizumab should be reserved for highly multiple allergen sensitivities or perennial-only sensitivities.ObjectiveTo examine impact of allergy burden, including number type sensitivities, on response a real-world setting.MethodsThis post hoc analysis evaluated subset omalizumab-treated from the Prospective Observational Study to Evaluate Predictors Clinical Effectiveness Response Omalizumab (NCT01922037) who had completed 13 assessments (N=478). Patients were classified by burden (nonsensitized, 1, 2-4, ≥5 sensitivities) seasonal, perennial, both). Outcome measures included exacerbation rate vs previous year improvements lung function Asthma Quality Life Questionnaire (AQLQ).ResultsComparable adjusted rates observed after initiation, regardless sensitizations (0.56-0.85/y). Improvements forced expiratory volume 1 second baseline at months 6 (0.03-0.09 L) 12 (–0.08 0.08 also similar across subgroups. Least squares mean change AQLQ (1.0-1.2) (1.1-1.4) was comparable patient subgroups, percentages achieved minimal clinically important difference least 0.5-point improvement month (71%-75%), which maintained improved (71%-89%). In all analyses, 95% confidence intervals overlapped.ConclusionOverall findings suggest distinct outcome therapy setting, sensitizations.Trial RegistrationClinicalTrials.gov Identifier: NCT01922037.