Omalizumab Treatment in Children 6 to 18 Years Old with Severe Asthma at a Children’s Medical Center

Abstract

Omalizumab is a monoclonal antibody that decreases IgE levels and has been shown to decrease asthma exacerbations, emergency care visits, and hospitalizations when added on to standard medical therapy for moderate–severe persistent asthma. We describe the results of omalizumab treatment in children 6 to 18 years old with severe asthma at a single pediatric medical center. This is a retrospective analysis of 27 children, 13 ± 3 years old, with severe asthma evaluated before and after treatment with omalizumab. Their baseline data were compared to 34 children with moderate–severe persistent asthma, 11 ± 3 years old, and to 65 children with mild persistent asthma, 10 ± 3 years old. Medication use, pulmonary function tests, IgE levels, and aeroallergen sensitivity differences were analyzed among moderate to severe asthmatics and mild asthmatics. Pulmonary function tests, quality of life questionnaires, and reduction of inhaled corticosteroid (ICS) doses were evaluated during omalizumab treatment. Children with severe persistent asthma treated with omalizumab had significantly different demographics compared to children with mild persistent asthma: increased African American children (p < 0.001), increased IgE level (p < 0.01), increased prevalence of sensitivities to house dust mite (p < 0.05) and cockroach (p < 0.01). The demographics of children with moderate–severe asthma were similar to children treated with omalizumab. Children treated with omalizumab had significant improvements in their pulmonary function (p < 0.001) and asthma control (p < 0.002). Omalizumab significantly improved asthma control and pulmonary function in children with severe persistent asthma in this study. These children with moderate–severe persistent asthma had increased total IgE levels and increased sensitivities to house dust mite and cockroach allergens.