TOPLINE:

The administration of omalizumab, either alone or in combination with subcutaneous allergen immunotherapy (SCIT) for house dust mites (HDMs), was associated with improved clinical outcomes over 36 months in patients with HDM-sensitized mild-to-moderate allergic asthma.

METHODOLOGY:

• Researchers conducted a randomized trial to compare the effectiveness of omalizumab, SCIT for HDMs, and their combination in 79 patients with HDM-sensitized mild-to-moderate allergic asthma.
• Patients received omalizumab (n = 17; mean age, 23.1 years; 48% women), SCIT for HDMs (n = 21; mean age, 20.3 years; 54% women), their combination (n = 20; mean age, 25.6 years; 50% women), or standard therapy (n = 21; mean age, 26.2 years; 52% women) for 36 months.
• Omalizumab was given at 150-450 mg every 4 weeks; the SCIT groups received HDM extract, starting with an initial dose of 0.1 mL, with stepwise up-titration to a maintenance dose of 0.5 mL administered every 4 weeks.
• The primary outcomes were changes in the daily dose of inhaled corticosteroids and the annual rate of asthma exacerbations over 36 months.

TAKEAWAY:

• During the 36 months of treatment, all groups showed significant reductions in the daily dose of inhaled corticosteroids; the reductions were greater with omalizumab plus SCIT than with SCIT alone or standard therapy (P < .05).
• In the third year, those who received the combination of omalizumab and SCIT had the lowest annual rates of asthma exacerbations and showed greater reductions in oral steroid use than the other groups (P < .05 for both).
• Improvements in lung function and asthma-related quality of life and reductions in clinical symptoms and medication use were more consistent with omalizumab plus SCIT.
• In the third year, nearly half of patients on the combination therapy (47%) met the exploratory criteria for clinical remission. No systemic hypersensitivity reactions or treatment-related serious adverse events were reported.

IN PRACTICE:

"The combination of omalizumab and allergen-specific immunotherapy has emerged as a promising approach for patients with allergic asthma, particularly in those sensitized to house dust mites. These improvements included reductions in inhaled corticosteroid use and asthma exacerbations, as well as improvements in asthma control, lung function, and quality of life," the authors of the study wrote. 

SOURCE:

Andrzej Bozek, with the Medical University of Silesia, Katowice, Poland, was the corresponding author of the study, which was published online on April 15, 2026, in the Journal of Asthma.

LIMITATIONS: 

This study had a small sample size and was not powered to detect differences across all outcomes, especially remission, and individual responses may have influenced group-level results. Because patients often had frequent exacerbations and suboptimal disease control, the findings may not generalize to broader populations with well-controlled mild asthma.

DISCLOSURES:

The study was supported by the Medical University of Silesia in Katowice, Poland. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.