Omalizumab: a quarter of a century in the fight against T2-inflammatory diseases of upper and lower respiratory tract

Abstract

T2 inflammation underlies diseases such as bronchial asthma, allergic rhinitis and chronic rhinosinusitis with nasal polyps. These diseases often have a severe course and often accompany each other, which leads to a significant decrease in the quality of life of patients. Studying the mechanisms of inflammation at the molecular level has made it possible to develop immunobiological drugs aimed at different stages of pathogenesis. One of the targets of immunobiological therapy for T2 inflammation, which can be affected by monoclonal antibodies, is immunoglobulin E. The purpose of the scientific review is to summarize the data accumulated over the past 25 years from randomized clinical trials and studies of real clinical practice on the effectiveness and safety of the original anti-IgE drug – “omalizumab”, including in comorbid patients. Clinical trials have shown that the use of omalizumab in patients with severe bronchial asthma reduces the frequency of exacerbations and severe exacerbations of asthma, reduces the number of hospitalizations and emergency room visits due to asthma exacerbations, reduces oral and inhaled glucocorticosteroids doses, improves respiratory function and improves quality of life. Omalizumab reduces the severity of nasal and ocular symptoms and reduces the need for antihistamines in patients with severe allergic rhinitis. Omalizumab effectiveness in patients with chronic rhinosinusitis with nasal polyps is manifested by decrease in nasal symptoms (nasal congestion, rhinorrhea), improvement in the sense of smell, decrease in polyps size, and the need for systemic glucocorticosteroids and surgical interventions. Omalizumab showed good tolerability and safety profile comparable to placebo in both clinical trials and routine practice.