Allergo Journal

, Volume 28, Issue 1, pp 16–19 | Cite as

Comparison of extended intervals and dose reduction of omalizumab for asthma control

  • Georg Bölke
  • Martin K. ChurchEmail author
  • Karl-Christian Bergmann



The necessary treatment duration of omalizumab in patients with severe asthma remains unclear. Currently, common practice is life-long therapy without adjustment of dose or treatment intervals. This study evaluated asthma control after either dosage interval extension or dose reduction in patients with asthma controlled by omalizumab.


Thirty-seven patients were assigned to receive either extended treatment interval (n = 26) or a reduction in omalizumab dosage (n = 11). The primary outcome was time until loss of asthma control.


Nineteen patients (73 %) of the extended interval group maintained good asthma control for at least 7–39 months. Of the remaining 7 patients, the median time to loss of asthma control was 8 months (range 5–35 months). In contrast, all patients in the dose reduction group lost asthma control. The median time of loss of control was 2 months (1–44 months). Extension of dose interval led to a significantly (P < 0.001) longer period of good asthma control than dose reduction.


If patients or physicians wish to reduce the cumulative dose of omalizumab after achieving good asthma control, extension of the interval between doses appears to be a better approach than dose reduction.


asthma omalizumab anti-IgE allergy dose adjustment 


  1. 1.
    Hekking PP, Wener RR, Amelink M, Zwinderman AH, Bouvy ML, Bel EH. The prevalence of severe refractory asthma. J Allergy Clin Immunol. 2015;135:896–902CrossRefGoogle Scholar
  2. 2.
    Collaborators GCRD. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017;5:691–706CrossRefGoogle Scholar
  3. 3.
    Global Initiative for Asthma. Global strategy for asthma management and prevention 2018. 2018. Accessed 18 Apr 2018.Google Scholar
  4. 4.
    Humbert M, Busse W, Hanania NA, Lowe PJ, Canvin J, Erpenbeck VJ, et al. Omalizumab in asthma: an update on recent developments. J Allergy Clin Immunol Pract. 2014;2:525–536.e1CrossRefGoogle Scholar
  5. 5.
    Normansell R, Walker S, Milan SJ, Walters EH, Nair P. Omalizumab for asthma in adults and children. Cochrane Database Syst Rev. 2014; Scholar
  6. 6.
    Abraham I, Alhossan A, Lee CS, Kutbi H, MacDonald K. ‘Real-life’ effectiveness studies of omalizumab in adult patients with severe allergic asthma: systematic review. Allergy. 2016;71:593–610Google Scholar
  7. 7.
    Alhossan A, Lee CS, MacDonald K, Abraham I. “Real-life” effectiveness studies of Omalizumab in adult patients with severe allergic asthma: meta-analysis. J Allergy Clin Immunol Pract. 2017;5:1362–1370.e2CrossRefGoogle Scholar
  8. 8.
    Licari A, Marseglia G, Castagnoli R, Marseglia A, Ciprandi G. The discovery and development of omalizumab for the treatment of asthma. Expert Opin Drug Discov. 2015;10:1033–42CrossRefGoogle Scholar
  9. 9.
    Lowe PJ, Renard D. Omalizumab decreases IgE production in patients with allergic (IgE-mediated) asthma; PKPD analysis of a biomarker, total IgE. Br J Clin Pharmacol. 2011;72:306–20CrossRefGoogle Scholar
  10. 10.
    Ledford D, Busse W, Trzaskoma B, Omachi TA, Rosén K, Chipps BE, et al. A randomized multicenter study evaluating Xolair persistence of response after long-term therapy. J Allergy Clin Immunol. 2017;140: 162–169.e2CrossRefGoogle Scholar
  11. 11.
    European Medicines Agency. Xolair, INN-omalizumab. 2009. Accessed 18 Apr 2018, Last updated: October 10 2016Google Scholar
  12. 12.
    Molimard M, Mala L, Bourdeix I, Le Gros V. Observational study in severe asthmatic patients after discontinuation of omalizumab for good asthma control. Respir Med. 2014;108:571–6CrossRefGoogle Scholar
  13. 13.
    Nopp A, Johansson SG, Adédoyin J, Ankerst J, Palmqvist M, Oman H. After 6 years with Xolair; a 3-year withdrawal follow-up. Allergy. 2010;65:56–60CrossRefGoogle Scholar
  14. 14.
    Katz RM, Rafi AW, Do LT, Lin R, Mangat R, Azad N, Sender S. Efficacy of Omalizumab using extended dose intervals. J Allergy Clin Immunol. 2007;119 (1 Suppl):S212CrossRefGoogle Scholar
  15. 15.
    Benouni S, Sheinkopf LE, Do LT, Rafi A, Katz RM. Extended Omalizumab dosage intervals and efficacy. J Allergy Clin Immunol. 2014;133(2 Suppl):AB3CrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Georg Bölke
    • 1
  • Martin K. Church
    • 1
    • 2
    • 3
    Email author
  • Karl-Christian Bergmann
    • 1
  1. 1.Department of Dermatology and AllergyCharité — Universitätsmedizin BerlinBerlinDeutschland
  2. 2.Division of Infection, Inflammation and Repair, Southampton General HospitalUniversity of Southampton School of MedicineSouthamptonUK
  3. 3.Division of Infection, Inflammation and Repair Mail Point 825 South BlockSouthampton General Hospital University of Southampton School of MedicineSouthamptonUK

Personalised recommendations