Age of asthma onset does not impact the response to omalizumab

Different ages of asthma onset can lead to similar clinical symptoms but have different underlying mechanisms that may influence treatment response. This post-hoc analysis assessed response to omalizumab in relation to the age of asthma onset. Using pooled data from two phase III studies (patients 12–75 years), changes in exacerbation rates, forced expiratory volume in 1 second (FEV(1)) and inhaled corticosteroids (ICS) were assessed by age of asthma onset (<18 [n = 574], 18–40 [n = 360], >40 years [n = 136]). Exacerbations (week 16) were reduced with omalizumab versus placebo in all subgroups (relative rate reduction [95% confidence interval]: <18, −53.1% [–73.6,–16.6]; 18–40, −68.3% [–85.5,–31.0]; >40, −38.4% [–77.3,67.4]). FEV(1) increased with omalizumab in all subgroups; increases were sustained in <18 and 18–40 years subgroups, but not in >40 years subgroup. ICS dose reductions (week 28) were greater with omalizumab versus placebo, regardless of age of asthma onset, as were percentages of patients with ICS doses reduced by at least 50% and 100%. In conclusion, omalizumab-treated patients had lower exacerbation rates and were more frequently able to reduce/discontinue ICS versus placebo, regardless of age of asthma onset, therefore omalizumab may be beneficial to all eligible patients with allergic asthma. TRIAL REGISTRATION: These studies were conducted before clinical trial registration was required; therefore, clinical trial registration numbers are not available.