Use of omalizumab in a severe asthma clinic.

There is an urgent need to define new treatment strategies for severe persistent asthma. Using a severe asthma clinic model, it is possible to systematically assess diagnosis, self-management skills, and treatment efficacy. The addition of single-patient trials of therapy is useful to detect individual responders to drugs where use is limited because of access, cost, or toxicity. Omalizumab is effective in severe asthma, however access is restricted by cost and availability. We conducted single patient efficacy trials of omalizumab in 12 subjects with severe refractory asthma. There were 2 definite and 6 partial responders. Patients with difficult/therapy resistant or refractory asthma can respond to omalizumab, and this response can be detected in individual patients using a single patient controlled trial conducted in the setting of a severe asthma clinic.