Omalizumab: a second look in severe persistent asthma: new adverse effects

When severe asthma persists despite high-dose inhaled corticosteroid therapy, it is better to switch to oral corticosteroid therapy than to add another asthma drug. In 2007, we concluded that omalizumab had a negative risk-benefit balance in this setting. In mid-2010, we found no new data on the efficacy of omalizumab. At best, omalizumab prevents 1 emergency room visit approximately every 2.5 years. Post-marketing follow-up data confirm the infectious adverse effects and hypersensitivity reactions associated with omalizumab, and show that anaphylactic reactions can occur several days after an injection. A possible increase in the risk of cancer has not yet been ruled out. New adverse effects associated with omalizumab have emerged, including serious cardiac effects and severe thrombocytopenia. In practice, despite longer followup, the efficacy of omalizumab remains uncertain, while new, sometimes serious adverse effects have emerged. It is better to adjust standard treatments to the individual's situation than to risk using omalizumab.