Respiratory Medicine
Volume 104, Issue 2 , Pages 188-196, February 2010

Effect of omalizumab on peripheral blood eosinophilia in allergic asthma

  • M. Massanari

      Affiliations

    • Novartis Pharmaceuticals Corp., East Hanover, NJ 07936-1080, USA
    • Corresponding Author InformationCorresponding author. Tel.: +44 862 778 7843. Mobile: 973 896 2802.
  • ,
  • S.T. Holgate

      Affiliations

    • Southampton General Hospital, Southampton, UK
  • ,
  • W.W. Busse

      Affiliations

    • University of Wisconsin, USA
  • ,
  • P. Jimenez

      Affiliations

    • Novartis Pharmaceuticals Corp., East Hanover, NJ 07936-1080, USA
  • ,
  • F. Kianifard

      Affiliations

    • Novartis Pharmaceuticals Corp., East Hanover, NJ 07936-1080, USA
  • ,
  • R. Zeldin

      Affiliations

    • Novartis Pharmaceuticals Corp., East Hanover, NJ 07936-1080, USA

Received 23 December 2008; accepted 17 September 2009. published online 21 October 2009.

Summary 

Eosinophilia is an established marker of asthma-related inflammation. We assessed the effect of omalizumab on peripheral blood eosinophil counts using a pooled analysis of data from five randomized, double-blind, placebo-controlled studies in patients with moderate-to-severe persistent allergic asthma receiving moderate-to-high-dose inhaled corticosteroids (omalizumab, n=1136; placebo, n=1100). Relationships between omalizumab, peripheral blood eosinophils, serum free IgE concentrations and clinical outcomes were explored. Baseline mean eosinophil counts were similar in each treatment group. Post-treatment eosinophil counts were significantly reduced from baseline in the omalizumab group (p<0.0001) but were not significantly different in the placebo group. Greater reductions in eosinophil counts were observed in patients who had post-treatment free IgE levels <50ng/mL. Three studies included steroid-stable and steroid-reduction phases. At the end of each phase in these studies, a significantly greater reduction in eosinophil counts was achieved in the omalizumab group compared with the placebo group (p<0.0001). A consistent pattern of improved clinical outcomes/decreased eosinophils and worsened clinical outcomes/increased eosinophils was observed for both omalizumab and placebo treatment groups. The findings from our analysis of a large patient population are consistent with earlier reports of the inhibitory effect of omalizumab on eosinophils.

Keywords: Omalizumab, IgE, Eosinophils, Allergy, Asthma

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PII: S0954-6111(09)00310-2

doi:10.1016/j.rmed.2009.09.011

Respiratory Medicine
Volume 104, Issue 2 , Pages 188-196, February 2010