Omalizumab: overview of pharmacology and efficacy in asthma

Background: Omalizumab is a monoclonal, humanized antibody specific for the region of IgE that binds to the high affinity IgE receptor on basophils and mast cells. Subcutaneous administration of omalizumab reduces the serum IgE concentration within hours and reduces the number of high affinity IgE receptors expressed on basophils and mast cells over 8 - 12. weeks Methods: A literature search of PubMed was performed using terms omalizumab or monoclonal and asthma. Results/conclusion: Asthma exacerbations are reduced by 19 - 75% with omalizumab therapy added to inhaled corticosteroid therapy, with or without long acting beta agonists and leukotriene modifiers. Approximately 60% of treated subjects show a response and 12 - 16 weeks are generally needed to evaluate response. Omalizumab is cost-effective if high-risk responders are treated. Side effects include 0.2% frequency of systemic reactions to the injections and 2% of subjects with local injection reactions, which do not usually require treatment.