Abstract
It is stated that benefit of omalizumab treatment in severe IgE-dependent asthma requires serum free IgE concentrations below 50 ng/ml. It is unclear if monitoring free serum IgE is clinically meaningful once omalizumab treatment is initiated. Free IgE and omalizumab serum concentrations were quantified in 22 patients with severe asthma (68% female, 47±11 yrs., mean (±SD) pre-bronchodilator FEV 1 62±13%, baseline mean (±SEM) free serum IgE 652±136 ng/ml) treated with omalizumab for 4 months using a Recovery-ELISA. Omalizumab treatment reduced free serum IgE prior to the second omalizumab injection by 73%, after 16 weeks by 81% to 58±12 ng/ml (p Monitoring free IgE and omalizumab serum concentrations in patients treated with omalizumab does not predict clinical response or add to the decision to continue or stop treatment. The relevance of free IgE measurements is limited to demonstrating an adequate reduction in non-responders. These results question the free IgE target range postulated to be necessary for a treatment response.
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