Omalizumab is effective in reducing asthma exacerbations irrespective of concomitant long-acting beta2-agonist use

Abstract

Rationale Anti-IgE therapy with omalizumab reduces asthma exacerbations in patients with allergic asthma. Here we evaluate whether the efficacy of omalizumab is similar in moderate-severe allergic asthma patients receiving and not receiving long-acting beta2-agonists (LABAs). Methods Data from 3 randomized controlled studies that allowed the used of LABAs were analyzed. Two of these studies were open-label in patients with allergic asthma and the third was a double-blind, placebo-controlled study in patients with concomitant allergic asthma and persistent allergic rhinitis. All patients had moderate-severe allergic asthma requiring inhaled corticosteroids. 206/312, 1221/1840 and 209/405 patients received omalizumab (at least 0.016 mg/kg/IgE [IU/mL]) in each of the studies, respectively. Poisson regression was used to investigate the effect of omalizumab treatment on asthma exacerbation rates in patients receiving and not receiving concomitant LABAs. Results LABA use was similar between the omalizumab and control groups in each study (77.7 vs 78.3, 87.6 vs 88.2 and 41.1% vs 36.2%, respectively). Omalizumab reduced asthma exacerbation rates in all studies. The relative rates of asthma exacerbations among omalizumab-treated patients compared with control were similar in patients irrespective of whether they received LABAs. The relative rates of asthma exacerbations with and without LABA use were 0.41 and 0.35 in study 1, 0.77 and 0.91 in study 2 and 0.66 and 0.59 in study 3, respectively. Conclusions Omalizumab is an effective add-on therapy in moderate-severe asthma, and its benefit is not affected by whether patients also receive long-acting beta2-agonists.