The Management of Severe Asthma
Treatment Options for Severe Asthma
Carlos E. Baena-Cagnani, Catholic University of Cordoba
The prevalence of asthma is rising all over the world and there is evidence that the number of patients suffering from severe asthma has increased. This is a very important issue since patients with severe asthma incur 50 percent of the public health expenditure on asthma. Severe asthma induces a dramatic deterioration in quality of life, with social and economic implications, as well as the anxiety associated with near fatal asthma or the potential of an asthma death.
Options evauated for the treatment of severe asthma include cyclosporin, methrotrexate, gold salts, IVIG, among others, however, the outcomes are variable and unpredictable, and therefore, these medications are not adequate treatment options for severe asthma. Recently, omalizumab, a humanized monoclonal antibody against IgE, has been launched in some countries including the U.S. , and it has also recently been approved in the European Union. IgE is pathologically associated with allergic asthma, and omalizumab is recommended for administration in patients with severe allergic asthma.
Clinical studies have clearly demonstrated that omalizumab is effective and safe in patients suffering from severe asthma. Omalizumab significantly reduced emergency room visits as well as unscheduled doctor visits, and also asthma related hospitalizations in both children and adults. In addition, omalizumab was shown to significantly increase the quality of life of patients suffering from severe asthma. Clinical efficacy was demonstrated by patients being able to reduce corticosteroid doses, and lung function was improved. An anti-inflammatory effect of omalizumab has also been demonstrated. It has an excellent safety profile, with adverse events similar to those found in the placebo group. Omalizumab is an important new option for the treatment of patients with severe allergic asthma.