Omalizumab for Asthma in Children With High Pretreatment Serum IgE Levels

asian child girl patient receiving artificial ventilation in hospital
Is omalizumab beneficial for children with asthma whose pretreatment serum IgE levels are above the drug manufacturer’s age-approved therapeutic range?

The following article is a part of conference coverage from the American Academy of Allergy, Asthma & Immunology Annual Meeting, being held in Phoenix, Arizona, from February 25 to 28, 2022. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the AAAAI 2022 Virtual Annual Meeting.

Use of omalizumab in children with asthma and pretreatment serum immunoglobulin E (IgE) levels higher than recommended by the drug manufacturer is associated with improved lung function, fewer emergency department (ED) visits, and less use of systemic corticosteroids. These were among findings of research presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting, held in Phoenix, Arizona, February 25 to 28.

In the current study, researchers sought to evaluate the use of omalizumab in patients with pediatric asthma whose pretreatment serum IgE levels were above the age-approved therapeutic range (ie, >1300 IU/mL in those 6 to 11 years of age and >700 IU/mL in those ≥12 years of age). The retrospective study assessed lung function, rate of ED visits, hospitalizations, and systemic corticosteroid use prior to and 12 months after omalizumab initiation.

A total of 11 participants under 12 years of age and 6 participants 12 years and over were enrolled in the study. The mean participant age was 10.35±3.89 years. The mean pretreatment serum total IgE level was 2763±1600 IU/mL.

The researchers found that after mean percent predicted forced expiratory volume in 1 second increased significantly from 87.1% pre-omalizumab use to 96.2% post-omalizumab use (P =.03). Additionally, the forced expiratory flow at 25% to 75% increased significantly from 67.8% pre-omalizumab treatment to 83.7% post-omalizumab treatment (P =.01). Further, ED visits decreased significantly from 2.4±3.2 visits per year pre-omalizumab to 0.7±1.7 visits per year post-omalizumab (P =.0002). No statistically significant changes in hospitalizations per year were reported between the pre-omalizumab period and the post-omalizumab period. The use of systemic corticosteroids decreased significantly from 3.7±3.4 courses per year pre-omalizumab therapy to 1.4±1.8 courses per year post-omalizumab therapy (P <.0001).

The investigators concluded that the use of omalizumab in children with asthma and high pretreatment serum IgE levels is associated with improved outcomes.


Atkinson C, Burbank A, Schworer S, Hernandez M. Omalizumab treatment is associated with improvement in outcomes in children with asthma despite pretreatment with serum IgE exceeding dosing guidelines. Presented at: American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting; February 25–28, 2022; Phoenix, AZ. Abstract 047.                                                                                                                                                                                                                                       


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