Asthma is a common chronic respiratory condition affecting over 330 million people globally. The GINA 2021 report recommends treatment with a combination of inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) in patients with moderate-to-severe asthma. In addition, add-on therapy with a long-acting muscarinic antagonist (LAMA) is suggested in individuals inadequately controlled on high-dose inhaled corticosteroid/long-acting β2-agonist (ICS/LABA).
Despite current therapeutic options, some individuals with asthma continue to remain symptomatic and experience hazardous asthma exacerbations, highlighting a need for a change in their existing treatment strategy. Although only a tiny proportion (~10%) of the total asthma population is identified as having critical or hard-to-treat asthma, roughly 50% of all asthma-related costs are attributed to this population.
Omalizumab for Treatment of Asthma:
Omalizumab, an anti-immunoglobulin E (anti-IgE) agent (supplied under the brand Xolair) is prescribed as an add-on therapy for those with uncontrolled severe allergic asthma (SAA) (patients aged ≥ 6 years), despite high-dose inhaled corticosteroid/long-acting β2-agonist (ICS+LABA) combination therapy. Certain previous clinical studies have demonstrated that add-on therapy with omalizumab helps improve disease control by scaling down symptoms and exacerbations and is well tolerated in those with severe allergic asthma (SAA).
Omalizumab is a monoclonal antibody, a sort of protein, designed to attach to IgE, which is created on large scales in individuals with allergies and triggers an allergic reaction in response to an allergen. By attaching to IgE, the medicine omalizumab ‘mops up’ the free IgE in the blood. This means that when the body encounters an allergen, there is less IgE present to trigger an allergic reaction. This helps to reduce the symptoms of asthma attacks.
Omalizumab has persistently proved promising in enhancing asthma symptom control irrespective of the scale that was used to measure its efficacy. It is also promising in reducing corticosteroid usage both inhaled and systematic, thus minimizing the catastrophic side effects of corticosteroids in those with asthma. The therapeutic drug also reduces the exacerbation rate in individuals with severe allergic asthma (SAA). Overall, omalizumab offers a rather safe profile, even though long-term cohort studies are crucial to evaluate its relative risk, if there is any, for some critical side effects such as malignancies and abortions. Omalizumab also seems to enhance various parameters of lung function.