Omalizumab in patients with severe asthma and persistent sputum eosinophilia.

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.

Déclaration de conflit d'intérêts

PN reports grants from AZ, Novartis (current submitted manuscript), Teva, Sanofi. He has received consultant fees from Roche, Teva, Novartis, Knopp, outside the submitted work. MM no conflicts of interest to declare. CL reports grants from AZ and TEVA Innovation. She has received consultant fees from AZ, GSK, Sanofi Genzyme, Teva Innovation, outside the submitted work. RL has received grant funding from AstraZeneca, MedImmune, Novartis and Sanofi (outside the submitted work and paid to his institution) and honoraria and speaker’s fees from AstraZeneca, the Canadian Thoracic Society and Teva Canada. SW has received grant funding from MedImmune, and honoraria from Novartis Astra Zeneca, and Teva Canada. MM, MK, KR, CH has nothing to declare.