Kenny Y C Kwong1, Craig A Jones. 1. Division of Allergy-Immunology, Department of Pediatrics, Los Angeles County+University of Southern California Medical Center, California 90033, USA. kkwongusc@yahoo.com
Abstract
BACKGROUND: Dosing of the anti-IgE antibody (omalizumab) in the treatment of allergic asthma depends on serum IgE concentration and body weight. It is unclear whether omalizumab is therapeutically effective in obese patients with difficult-to-control asthma whose body weights fall outside dosing guidelines. OBJECTIVE: To report the efficacy of omalizumab in 2 obese pediatric patients with severe persistent asthma whose high body weights placed them outside current dosing guidelines. METHODS: Omalizumab was given at maximum doses to both patients. Standard asthma therapy was continued throughout the treatment period. Multiple parameters of asthma disease activity were followed at every health encounter for approximately 1 year during and before omalizumab treatment. These parameters included asthma disease severity and activity, pulmonary functions, daily inhaled corticosteroid requirements, systemic steroid rescue, and urgent care and emergency department visits and hospitalizations. RESULTS: While receiving omalizumab, both patients had improvements in asthma disease activity and reduction in systemic steroid requirements. One patient required fewer daily inhaled corticosteroids and achieved total asthma control. CONCLUSION: Patients with difficult-to-treat asthma may benefit from receiving omalizumab even if they fall outside current dosing guidelines because of high body weight.
BACKGROUND: Dosing of the anti-IgE antibody (omalizumab) in the treatment of allergic asthma depends on serum IgE concentration and body weight. It is unclear whether omalizumab is therapeutically effective in obesepatients with difficult-to-control asthma whose body weights fall outside dosing guidelines. OBJECTIVE: To report the efficacy of omalizumab in 2 obese pediatricpatients with severe persistent asthma whose high body weights placed them outside current dosing guidelines. METHODS:Omalizumab was given at maximum doses to both patients. Standard asthma therapy was continued throughout the treatment period. Multiple parameters of asthma disease activity were followed at every health encounter for approximately 1 year during and before omalizumab treatment. These parameters included asthma disease severity and activity, pulmonary functions, daily inhaled corticosteroid requirements, systemic steroid rescue, and urgent care and emergency department visits and hospitalizations. RESULTS: While receiving omalizumab, both patients had improvements in asthma disease activity and reduction in systemic steroid requirements. One patient required fewer daily inhaled corticosteroids and achieved total asthma control. CONCLUSION:Patients with difficult-to-treat asthma may benefit from receiving omalizumab even if they fall outside current dosing guidelines because of high body weight.