Omalizumab shows promise in severe pediatric atopic dermatitis

  • Chan S & al.
  • JAMA Pediatr
  • 25 Nov 2019

  • International Clinical Digest
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Takeaway

  • Omalizumab (Xolair) was tied to reduced eczema severity and improved QoL in this randomized clinical trial with 62 children.
  • Children in the omalizumab group also had “markedly potent” topical corticosteroid sparing.

Why this matters

  • Omalizumab looks promising for children with recalcitrant severe eczema and atopy.
  • Editorial: “rigorous” trial has yielded positive results, but an open question is the 6-figure annual cost of this medication.

Key results

  • Drug group had markedly improved symptom scores vs placebo group (P=.01).
  • QoL scores were also better for children in the omalizumab group.
  • Children taking omalizumab were able to have lower use of potent topical steroids in terms of body surface area covered: 16% for drug group omalizumab vs 31% with placebo.
  • They also had fewer days of topical steroid use.
  • 13% withdrew from placebo group and 3% from the omalizumab group.

Study design

  • 24-week, single-center, double-blind, placebo-controlled, randomized Atopic Dermatitis Anti-IgE Pediatric Trial.
  • 62 children (30 drug; 32 placebo); mean age, 10.3 (range, 4-19) years; 52% boys.
  • Funding: UK National Institute of Health Research; others.

Limitations

  • Topical steroids allowed ad libitum.
  • Small numbers in study.