[Omalizumab: What have we learned after ten years of prescription?
INTRODUCTION Omalizumab, an anti immunoglobulin E monoclonal antibody, has now been used for ten years as an add on therapy for severe adult atopic asthma, poorly controlled by high doses inhaled steroids and long acting beta agonists. BACKGROUND This innovative therapy has been the first biotherapy used on a large scale in severe asthma. It has shown clinical benefits, especially in the prevention of severe exacerbation, with a satisfactory safety profile. Despite its cost, it is an interesting alternative to continuous oral steroids, which cause more long term side effects. PERSPECTIVES After ten years of prescription of omalizumab, we review here the mechanism of action, the benefits, the main side effects, the cost effectiveness and also the alternative indications of this interesting molecule. We also consider the practicalities of using omalizumab, particularly the importance a rigorous assessment of its efficacy after 16 weeks of treatment, and possible future therapeutic indications. CONCLUSION Omalizumab has proven its efficacy in large randomized studies but also in real life practice in severe allergic asthma.
Revue des maladies respiratoires