Anti-IgE treatment in children with severe intrinsic asthma

Background: Omalizumab was suggested to improve asthma control in 5/7 children with severe intrinsic asthma [1]. Our aim was to assess its efficacy in severe intrinsic asthma in our paediatric population. Methods: Children with severe (GINA step 5), uncontrolled (Asthma Control Test ACT Results: Five children with severe intrinsic asthma [3 boys + 2 girls, median age 13.0 (range 8.3-15.2) yr, total serum IgE 51 (36-94) kIU/l] were started on omalizumab. In 2 children omalizumab was stopped at 16 wk, because of no improvement in ACT score. Clinical characteristics, inhaled corticosteroid (ICS) daily dose and lung function for the whole group are shown in the table (median and range). ACT significantly improved at 48 wk in the whole group. In the 3 responders ACT changed from 13 (10-14) at 0 wk to 22 (20-24) at 48 wk (p=0.109), while in the 2 non-responders it remained substantially unchanged [8 (7-9) vs 12.5 (10-15), p=0.180]. Conclusions: Despite the limitation of the small sample size, omalizumab determined a significant clinical improvement in children with severe intrinsic asthma. [1] Bourgoin-Heck M, et al. Pediatr Allergy Immunol 2018;29:90-117