Omalizumab home injection versus hospital administration in severe asthma: Impact on asthma control

Background: Initial studies recommended that omalizumab be administered by health-care professionals. However, subsequent research revealed that the prevalence of anaphylaxis after subcutaneous omalizumab injections was only 0.09%. Objective: In this study, we aimed to evaluate the effects of omalizumab self-administration at home compared with hospital administration on asthma control. Method: Medical records of 45 patients diagnosed with severe atopic asthma, treated with omalizumab in our clinic, and subsequently transitioned to self-injection at home after appropriate training were retrospectively reviewed. These patients were monitored regularly for at least 1 year before and after the transition. The asthma control level was assessed by using the Asthma Control Test (ACT). Results: The ACT score average 1 year after home use was significantly higher than 1 year before home use (0.047); however, the scores before and after 6 months and 3 months home use were similar. A significant reduction in the number of exacerbations was observed after home medication use (p = 0.050), whereas no significant differences were detected in systemic steroid use or emergency admissions. The presence of eosinophilia and comorbidities did not significantly affect periodic ACT values after home use. Conclusion: Our study demonstrated the safety and efficacy of omalizumab for home administration in patients with severe atopic asthma, and it should be emphasized that proper patient selection and training are crucial to ensure the safety of home therapy. It is effective in both symptom control and prevention of exacerbations, and the effectiveness of home use was not diminished by the presence of comorbidities or eosinophilia compared with hospital use.