Anti-IgE therapy of asthma

There is a strong association between serum levels of immunoglobulin E (IgE) and asthma development. Allergen binds to IgE on basophils and mast cells, leading to cell degranulation and release of inflammatory mediators. A humanized antibody to IgE that reduces circulating free IgE, omalizumab (Genentech Inc/Novartis AG/Tanox Inc), inhibits the early- and late-phase response to allergen. In clinical trials of moderate-to-severe asthma, omalizumab allowed a reduction in oral and inhaled corticosteroids while improving peakflows and reducing exacerbations, particularly in patients at high risk of serious asthma-related morbidity. Omalizumab is a useful addition to the treatment armamentarium for patients with moderate-to-severe asthma.