A clinical trial has found that the drug omalizumab, sold under the brand name Xolair, nearly eliminated seasonal increases in asthma attacks and decreased asthma symptoms among inner-city children and youth.
The study enrolled 419 children and youths, aged 6 to 20 years, diagnosed with moderate to severe allergic asthma lasting more than one year.
The children came from Boston, Chicago, Cleveland, Dallas, Denver, New York City, Tucson, Ariz. and Washington, D.C.
In addition to standard therapy, half of the participants were assigned at random to receive omalizumab, and the other half a placebo.
Drug or placebo was delivered via an injection under the skin every two to four weeks over the 60-week period of study.
As the trial proceeded, participants returned to the clinic every three months for evaluation of their symptoms.
At the end of the study, the investigators found that, overall, children and adolescents who received omalizumab had a 25 percent reduction in days with symptoms and a 30 percent reduction in asthma attacks compared with those who received placebo.
Those who received omalizumab also had a 75 percent reduction in hospitalizations.
Importantly, the spring and fall increases in asthma attacks that were seen in the participants receiving placebo were almost eliminated in those participants receiving omalizumab.
"The spike in asthma attacks in the fall, which is associated with colds and other viral airway infections, disappeared in the kids in the omalizumab group," said William Busse, the principal investigator of ICAC and professor of medicine at the University of Wisconsin-Madison.
"Because the drug specifically targets IgE, which is the antibody responsible for allergies, our observations show the possible interplay between allergies, respiratory viruses and IgE in provoking asthma attacks," he said.
Children and adolescents who responded the best to omalizumab had positive skin tests for cockroach allergy and high levels of cockroach allergen in their homes.
The findings appeared in the New England Journal of Medicine.