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Omalizumab Proves Effective For Severe Pediatric Atopic Dermatitis

Key clinical point: Treatment with omalizumab for 24 weeks reduced severity in pediatric atopic dermatitis patients.

Major finding: After 24 weeks, the adjusted mean difference in objective SCORAD index between the two groups was -6.9 in favor of omalizumab (95% CI, -12.2 to -1.5; P = .01).

Study details: A single-center, double-blind, placebo-controlled randomized clinical trial of 62 patients with childhood atopic dermatitis.

Disclosures: The study was funded by the National Institute for Health Research Efficacy and Mechanism Evaluation Programme and Guy's and St. Thomas' Charity. The authors had numerous financial disclosures, including receiving grants from the NIHR EME Programme and Guy's and St. Thomas' Charity along with active and placebo drugs from Novartis for use in the study.

Citation:

Chan S et al. JAMA Pediatr. 2019 Nov 25. doi: 10.1001/jamapediatrics.2019.4476.

Commentary:

Omalizumab, an IgE blocker, has been used for over a decade for severe asthma. It has been tried in patients with atopic dermatitis, usually on an individual case basis; and, although some success has been reported, it has not been uniformly effective. This is the first large trial showing impressive AD improvement with the drug. It is uncertain whether this is related to the baseline severity of AD, drug dosing, or some other disease parameters, but suggests that we may need to reconsider omalizumab as an option for severe AD treatment.— Joseph Fowler, Jr., MD, Clinical Professor of Dermatology, University of Louisville, KY