Please use this identifier to cite or link to this item:
Title: Real-life effectiveness of omalizumab in severe allergic asthma above the recommended dosing range criteria
Austin Authors: Hew, Mark;Gillman, A;Sutherland, Michael F;Wark, P;Bowden, J;Guo, M;Reddel, HK;Jenkins, C;Marks, GB;Thien, F;Rimmer, J;Katsoulotos, GP;Cook, M;Yang, I;Katelaris, C;Bowler, S;Langton, D;Wright, C;Bint, M;Yozghatlian, V;Burgess, S;Sivakumaran, P;Yan, KY;Kritikos, V;Peters, M;Baraket, M;Aminazad, A;Robinson, P;Jaffe, A;Powell, H;Upham, JW;McDonald, VM;Gibson, PG
Affiliation: Austin Health, Heidelberg, Victoria, Australia
The Alfred Hospital & Monash University, Melbourne, Victoria, Australia
Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, New Lambton Heights, NSW, Australia
Flinders Medical Centre, Bedford Park, South Australia, Australia
Woolcock Institute of Medical Research, Glebe, University of Sydney, NSW, Australia
Royal Prince Alfred Hospital, Camperdown, NSW, Australia
Concord Hospital, Concord, NSW, Australia
Liverpool Hospital, Liverpool, NSW, Australia
Box Hill Hospital, Box Hill, Victoria, Australia
St Vincent’s Clinic, Darlinghurst, NSW, Australia
St George Specialist Centre, Kogarah, NSW, Australia
Canberra Hospital, Woden, ACT, Australia
The Prince Charles Hospital, Chermside, Queensland, Australia
Campbelltown Hospital, Campbelltown, NSW, Australia
Mater Adult Hospital, South Brisbane, Queensland, Australia
Frankston Hospital, Frankston, Victoria, Australia
Nambour Hospital, Nambour, Queensland, Australia
St George Hospital, Kogarah, NSW, Australia
QLD Children’s Lung and Sleep Specialists, Queensland, Australia
Gold Coast District Hospital, Southport, Queensland, Australia
Children’s Hospital at Westmead, Westmead, NSW, Australia
School of Women’s and Children’s Health, UNSW Medicine, Randwick, NSW, Australia
Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
Issue Date: Nov-2016 2016-07-22
Publication information: Clinical & Experimental Allergy 2016; 46(11): 1407-1415
Abstract: BACKGROUND: Omalizumab (Xolair) dosing in severe allergic asthma is based on serum IgE and bodyweight. In Australia, patients eligible for omalizumab but exceeding recommended ranges for IgE (30-1500 IU/mL) and bodyweight (30-150 kg) may still receive a ceiling dose of 750 mg/4 weeks. About 62% of patients receiving government-subsidized omalizumab are enrolled in the Australian Xolair Registry (AXR). OBJECTIVES: To determine whether AXR participants above the recommended dosing ranges benefit from omalizumab and to compare their response to within-range participants. METHODS: Data were stratified according to dose range status (above-range or within-range). Further sub-analyses were conducted according to the reason for being above the dosing range (IgE only vs. IgE and weight). RESULTS: Data for 179 participants were analysed. About 55 (31%) were above recommended dosing criteria; other characteristics were similar to within-range participants. Above-range participants had higher baseline IgE [812 (IQR 632, 1747) IU/mL vs. 209 (IQR 134, 306) IU/mL] and received higher doses of omalizumab [750 (IQR 650, 750) mg] compared to within-range participants [450 (IQR, 300, 600) mg]. At 6 months, improvements in Juniper 5-item Asthma Control Questionnaire (ACQ-5, 3.61 down to 2.01 for above-range, 3.47 down to 1.93 for within-range, P < 0.0001 for both) and Asthma Quality of Life Questionnaire (AQLQ mean score (3.22 up to 4.41 for above-range, 3.71 up to 4.88 for within-range, P < 0.0001) were observed in both groups. Forced expiratory volume in one second (FEV1 ) improved among above-range participants. There was no difference in response between above-range and within-range participants. Above-range participants due to either IgE alone or IgE and weight had similar improvements in ACQ-5, AQLQ and FEV1 . CONCLUSIONS AND CLINICAL RELEVANCE: Patients with severe allergic asthma above recommended dosing criteria for omalizumab have significantly improved symptom control, quality of life and lung function to a similar degree to within-range participants, achieved without dose escalation above 750 mg.
DOI: 10.1111/cea.12774
PubMed URL:
Type: Journal Article
Subjects: Asthma
Dosing range
Appears in Collections:Journal articles

Show full item record

Page view(s)

checked on Dec 2, 2022

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.