Adverse Systemic Reaction Rates with Omalizumab, Subcutaneous Immunotherapy, and Combination Therapy in Children with Allergic Asthma
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Daniel Har, MD, Min Jung Lee, MD
RATIONALE: Subcutaneous immunotherapy (SCIT) is contraindicated in poorly controlled asthma. Our study compares the safety of combining omalizumab and SCIT versus omalizumab alone in children with moderate-severe persistent asthma. We hypothesize that the rate of adverse events (AE) in children receiving combination therapy is comparable to omalizumab alone.

METHODS: We performed a retrospective study of children ages 6-18 years old with allergic asthma from 07/2010-06/2017 who received SCIT, omalizumab, or combination therapy in our Children’s allergy clinic. All patients receiving omalizumab or combination therapy had moderate-severe persistent asthma. The rate of AEs was compared among each of these categories.

RESULTS: We reviewed 79 patients: 30 SCIT patients (1550 injections), 30 omalizumab patients (729 injections), and 29 combination therapy patients (954 injections). In the SCIT group, 19 AE (1.2% of injections) occurred in 10 patients (33%). In the omalizumab group, 3 AE (0.4% of injections) occurred in 3 patients (10%). Similarly in the combination group, 3 AE (0.3% of injections) occurred in 3 patients (10%). Compared to AE in SCIT group, both omalizumab and combination groups had significantly lower AE, p=0.045 and 0.011, respectively. AE in children receiving omalizumab and combination therapy were not statistically different (p=0.73).

CONCLUSIONS: Children with moderate-severe persistent allergic asthma receiving omalizumab or combination therapy had significantly lower AE compared to allergic asthmatic children receiving SCIT therapy. SCIT treatment in omalizumab-treated children is safe and may serve both as an omalizumab-sparing treatment and as a bridge to safely administer SCIT.