Real-life study in non-atopic severe asthma patients achieving disease control by omalizumab treatment.

Abstract

Severe asthma is defined as asthma requiring treatment with guide-lines-suggested medications for Global Initiative for Asthma (GINA)steps 4 or 5 or systemic corticosteroids for ≥50% of the previous yearto prevent it from becoming “uncontrolled” or which remains “uncon-trolled” despite this therapy.1 Up to 34%–50% of severe asthmatic pa-tients have non-atopic (also called non-allergic) asthma. 2 A significantproportion of these patients have severe uncontrolled asthma, whichrequires high doses of inhaled corticosteroids (ICS) or even oral cor-ticosteroids (OCS). 2 Until the advent of biologics, treatment optionsin these patients have been very limited. For many years, both thepathogenesis knowledge and the results of clinical trials supportedthe view that anti-IgE treatment is specifically effective in allergicasthma. 3 Interestingly, recent molecular and clinical evidence sug-gests that anti-IgE treatment might also be effective in patients withnon-allergic asthma. 2 Omalizumab (Xolair ®) is an anti-IgE monoclonalantibody that selectively binds to human IgE and prevents the bindingof IgE to its receptors. Although omalizumab is indicated in Europe inpatients with severe persistent allergic asthma, several case reportsand short series have provided data on the value of omalizumab inalso patients with non-atopic asthma.