Comparison of extended intervals and dose reduction of omalizumab for asthma control

The necessary treatment duration of omalizumab in patients with severe asthma remains unclear. Currently, common practice is life-long therapy without adjustment of dose or treatment intervals. This study evaluated asthma control after either dosage interval extension or dose reduction in patients with asthma controlled by omalizumab. Thirty-seven patients were assigned to receive either extended treatment interval ( n = 26) or a reduction in omalizumab dosage ( n = 11). The primary outcome was time until loss of asthma control. Nineteen patients (73%) of the extended interval group maintained good asthma control for at least 7–39 months. Of the remaining 7 patients, the median time to loss of asthma control was 8 months (range 5–35 months). In contrast, all patients in the dose reduction group lost asthma control. The median time of loss of control was 2 months (1–44 months). Extension of dose interval led to a significantly ( P < 0.001) longer period of good asthma control than dose reduction. If patients or physicians wish to reduce the cumulative dose of omalizumab after achieving good asthma control, extension of the interval between doses appears to be a better approach than dose reduction.