Allergen skin tests and free IgE levels during reduction and cessation of omalizumab therapy
Open accessAbstract
Background The recombinant humanized anti-IgE antibody omalizumab rapidly reduces serum free IgE concentrations and alleviates allergic airway disease. It is not known whether stopping or reducing the dose of omalizumab maintains adequate suppression of free IgE levels and IgE-mediated mast cell activation.Objective To determine the effects of omalizumab on serum free IgE and immediate allergen skin test reactivity during initial therapy followed by treatment reduction and cessation.Methods Forty patients with perennial allergic rhinitis were randomized to receive 0.015 or 0.030 mg/kg/IU/mL open-label intravenous omalizumab every 2 weeks for 28 weeks, followed by 0.0015 or 0.0050 mg/kg/IU/mL every 2 weeks for 18 weeks. Serum free IgE levels were measured and titrated dust mite allergen skin tests conducted throughout.Results At day 98, serum free IgE concentrations were decreased by 96% to 99%, and wheal-and-flare reactions to skin tests were markedly suppressed. After reduced omalizumab doses (day 322), serum free IgE and allergen skin test reactivity increased significantly. On complete discontinuation of therapy (day 378), serum free IgE levels and skin test reactivity returned to baseline levels. Patients with lower initial levels of IgE had significantly less suppression of skin test reactivity.Conclusion Omalizumab reduced serum free IgE and immediate skin test reactivity to allergen during initial, high-dose administration. These effects were not fully maintained during dose reduction and returned to baseline after cessation of chronic treatment.
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Omalizumab suppresses skin test reactivity in tandem with dramatic reductions in serum free IgE, and allergy skin test responses return to normal within 8 weeks of discontinuation.
“Omalizumab appears to suppress skin test reactivity in tandem with dramatic reductions in serum free IgE, and allergy skin test responses return to normal within 8 weeks of discontinuation.875”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [875]
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- Authors
- Corren, J., Shapiro, G., Reimann, J., Deniz, Y., Wong, D., Adelman, D., & Togias, A.
- Affiliations
- Genentech (US)
- Pharmacyclics (United States) (US)
- Johns Hopkins University (US)
- Corresponding author
- Corren, Jonathan
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2008-02
- Volume
- 121
- Issue
- 2
- Pages
- 506-511
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W1977639139
- Cited by
- 83
- References
- 19
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 4 · 2020: 5 · 2019: 6 · 2018: 7 · 2017: 6 · 2016: 5 · 2015: 5 · 2014: 6 · 2013: 3 · 2012: 2
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Amgen
- AstraZeneca
- GlaxoSmithKline
- Genentech
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- omalizumab, perennial allergic rhinitis, anti-IgE therapy, treatment dose reduction, treatment discontinuation, house dust mite allergens, wheal and flare, IgE-mediated mast cell activation
- MeSH terms
- Omalizumab, Adult, Antibodies, Anti-Idiotypic, Antibodies, Monoclonal, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Humans, Immunoglobulin E, Injections, Intravenous, Male, Rhinitis, Allergic, Perennial, Skin Tests, Anti-Allergic Agents, Antigens, Dermatophagoides, Antibodies, Monoclonal, Humanized
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