Long-term using of omalizumab in children with atopic severe persistent non-controlled asthma

Omalizumab (Omab) is a medication for treatment severe persistent atopic asthma in children older 6 y. There is few published data examining long-term Omab using in children. We report the experience of long-term treatment in school age children with difficult-to-treat asthma. Open-label observation study analyzed the efficacy and tolerability of Omab. Methods: Medical files of 53 children treated with Omab were reviewed and 4 treated with Omab during 48-49 (mean 48.5 mo) were chosen for report. The following data were recorded, at baseline and after 48.5 months of Omab treatment: maintenance therapy, PFTs values, symptom scores, control level (GINA), allergic features. Results: The characteristics of these 4 patients were: mean age of the beginning of Omab therapy - 13.2 y, 50% boys, initial maintenance therapy was ICS (mean daily dose: 1000µg fluticasone) with LABA, asthma symptom control questionnaires (mean ACT: 8, mean ACQ 22.5), mean FEV1 70.75%, mean PEF 68.7%. 100% had allergic rhinitis, 25% atopic dermatitis and 50% food allergy. After long-term Omab therapy following indices significantly improved: maintenance ICS doses (mean 337.5 µg fluticasone) with LABA, symptom scores (mean ACT: 18, mean ACQ 12.5), PFTs values (mean FEV1 103.5%, mean PEF 100.5%). Rescue medication requirement reduced on 80%, mean number of unscheduled medical contacts attributable to asthma exacerbation was significantly decreased. Patients or parents reported no significant adverse effects. Conclusions: Omalizumab improves control in children with atopic severe non-controlled asthma, reduces the rate exacerbations and asthma-related hospitalizations and reduces doses of maintenance and rescue medication.