Omalizumab beneficial in patients with moderate to severe allergic asthma regardless of BMI: Study

Effectiveness of asthma treatment, including biologics, may be different in patients with higher body mass index (BMI).

Researchers examined response to omalizumab (dosed by serum immunoglobin E level and weight) by BMI category.

Pooled data from 2 randomized, double-blind, placebo-controlled studies of adults with moderate-to-severe allergic asthma were analyzed by BMI category (<25 kg/m 2 [normal/underweight], n = 397; 25 to <30 kg/m 2 [overweight], n = 330; ≥30 kg/m 2 [obese], n = 268). Placebo-adjusted exacerbation rate reductions were assessed by Poisson regression modeling. Changes from baseline in forced expiratory volume in 1 second (FEV 1), beclomethasone dipropionate (BDP) dose, Total Asthma Symptom Score (TASS), and Asthma Quality of Life Questionnaire (AQLQ) were assessed by analysis of covariance.

Results of the study are:

Greater placebo-adjusted exacerbation rate reductions (95% confidence interval) were observed with increasing BMI (normal/underweight, −37.4% [−69.0%, 26.8%]; overweight, −52.7% [−78.4%, 3.7%]; obese, −71.9% [−86.9%, −39.5%]). There were no differences in FEV 1 improvement between BMI categories at week 16 (normal/underweight, 76.2 [5.3-147.1] mL; overweight, 98.1 [13.9-182.4] mL; obese, 69.1 [−18.9, 157.2] mL). No differences in BDP dose reduction (µg) were noted between BMI categories (normal/underweight, 23.0 [15.7-30.3]; overweight, 22.5 [13.5-31.5]; obese, 16.6 [5.8-27.3]). Fewer patients in the higher BMI categories eliminated BDP use. There were trends for smaller improvements with higher BMI in TASS (normal/underweight, −0.52 [−0.82, −0.22]; overweight, −0.50 [−0.80, −0.20]; obese, −0.39 [−0.77, 0.00]) and AQLQ (normal/underweight, 0.34 [0.16-0.52]; overweight, 0.34 [0.13-0.55]; obese, 0.15 [−0.08, 0.39]).

Thus, the researchers concluded that Omalizumab provides benefit to patients with moderate-to-severe allergic asthma, regardless of BMI.

Reference:

Omalizumab benefits patients with moderate to severe allergic asthma regardless of BMI, according to a recent study published in the Annals of Allergy, Asthma & Immunology.

https://www.annallergy.org/article/S1081-1206%2822%2900045-X/fulltext