Effects of adding omalizumab, an anti-immunoglobulin E antibody, on airway wall thickening in asthma

Respiration. 2012;83(6):520-8. doi: 10.1159/000334701. Epub 2012 Jan 11.


Background: Omalizumab may inhibit allergic inflammation and could contribute to decreasing airway remodeling in patients with asthma.

Objective: The aim of this study was to assess the effects of omalizumab on airway wall thickness using computed tomography (CT).

Methods: Thirty patients with severe persistent asthma were randomized to conventional therapy with (n = 14) or without omalizumab (n = 16) for 16 weeks. The following airway dimensions were assessed by a validated CT technique: airway wall area corrected for body surface area (WA/BSA), percentage wall area (WA%), wall thickness (T)/√BSA, and luminal area (Ai)/BSA at the right apical segmental bronchus. The percentage of eosinophils in induced sputum, pulmonary function and the Asthma Quality of Life Questionnaire (AQLQ) were assessed as well.

Results: Treatment with omalizumab significantly decreased WA/BSA (p < 0.01), WA% (p < 0.01), and T/√BSA (p < 0.01), and increased Ai/BSA (p < 0.05), whereas conventional therapy resulted in no change. In the omalizumab group (n = 14), a significant decrease in the percentage of sputum eosinophils (p < 0.01), improved forced expiratory volume in 1 s (FEV(1)), and an improved AQLQ score were recorded. The changes in FEV(1)% predicted and sputum eosinophils were significantly correlated with changes in WA% (r = 0.88, p < 0.001, and r = 072, p < 0.01, respectively).

Conclusions: These findings suggest that omalizumab reduced airway wall thickness and airway inflammation. Larger patient studies with longer-term follow-up are needed to show whether omalizumab can truly maintain improved airway wall dimensions.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anti-Asthmatic Agents / pharmacology*
  • Anti-Asthmatic Agents / therapeutic use
  • Antibodies, Anti-Idiotypic / pharmacology*
  • Antibodies, Anti-Idiotypic / therapeutic use
  • Antibodies, Monoclonal, Humanized / pharmacology*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Asthma / drug therapy
  • Asthma / pathology*
  • Asthma / physiopathology
  • Bronchi / drug effects*
  • Eosinophils / metabolism
  • Female
  • Forced Expiratory Volume
  • Humans
  • Inflammation / drug therapy
  • Male
  • Middle Aged
  • Omalizumab
  • Quality of Life
  • Respiratory Function Tests
  • Sputum / metabolism
  • Tomography, X-Ray Computed


  • Anti-Asthmatic Agents
  • Antibodies, Anti-Idiotypic
  • Antibodies, Monoclonal, Humanized
  • Omalizumab