Omalizumab helps patients with asthma with fixed airway obstruction

Published: August 19, 2021

Although most patients with asthma have airways that relax and widen when they take medications called bronchodilators, some patients have a condition called fixed airway obstruction. For these patients, the walls of the airways thicken over time and become stiff and unable to relax and widen. Patients with asthma with fixed airway obstruction have more exacerbations, decreased lung function, and higher mortality than patients with asthma who do not have fixed airway obstruction.

Omalizumab is an approved treatment for moderate-to-severe allergic asthma for patients aged 6 years and older. In many studies, omalizumab has been shown to reduce asthma exacerbations and improve lung function. However, we don’t know whether omalizumab has the same effect in patients with asthma with fixed airway obstruction, or in patients who don’t respond well to bronchodilators, for example albuterol.

A study looking at omalizumab in patients with asthma with fixed airway obstruction was conducted by Dr. Nicola Hanania and his colleagues and was recently published in The Journal of Allergy and Clinical Immunology: In Practice. This study looked at groups of patients participating in a previous study that looked at the effect of omalizumab treatment in patients aged 12 to 75 years with moderate-to-severe allergic asthma.

The study found that omalizumab reduced exacerbations in patients with asthma who responded well to bronchodilators, regardless of whether they had fixed airway obstruction or not. However, omalizumab did not work well in patients who did not respond to bronchodilators. Dr Hanania and his colleagues concluded that omalizumab would provide benefits for some patients with moderate-to-severe allergic asthma and fixed airway obstruction, but patients with or without fixed airway obstruction who did not respond well to bronchodilators were a more difficult group to treat.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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