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Which patients should be treated with anti-IgE?

CORRESPONDENCE: K-M Beeh, insaf Respiratory Research Institute, Biebricher Allee 34, D-65187 Wiesbaden, Germany. Fax: 49 6119854348. E-mail: k.beeh{at}insaf-wi.de

In the European Union, omalizumab is indicated as add-on therapy to improve asthma control in adult and adolescent patients (12 yrs of age) with severe persistent allergic asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen, and who, despite receiving daily high-dose inhaled corticosteroids and a long-acting ß₂-agonist, have the following characteristics: reduced lung function (forced expiratory volume in one second <80%); frequent daytime symptoms or night-time awakenings; and multiple documented severe asthma exacerbations. Omalizumab is indicated for patients with baseline total immunoglobulin E levels of 30–700 IU·mL^–1. Patients who receive omalizumab should be assessed by their physician after 16 weeks and treatment continued only if there has been a marked improvement in asthma control. Omalizumab is administered by subcutaneous injection every 2 or 4 weeks at a dosage determined using a dosing table based on the patient's pre-treatment serum total immunoglobulin E levels and body weight.

KEYWORDS: Clinical efficacy, exacerbations, omalizumab, patient selection, severe asthma