How Does Omalizumab Affect Antitussive Use in Patients With Allergic Asthma?

Omalizumab may decrease antitussive use in patients with allergic asthma, according to a study presented at the American Thoracic Society (ATS) International Conference 2022 held in San Francisco, CA, May 13 to 18.

Patients with allergic asthma who have acute and chronic cough may have poor asthma control. Inhaled corticosteroids (ICS) are recommended for cough management in these patients; however, prescription and over-the-counter antitussives are commonly used during asthma exacerbations. Omalizumab is an approved biologic therapy for moderate-to-severe persistent asthma, but data are lacking on how biologic therapy may affect cough or antitussive use.

Researchers for the current study performed a post-hoc analysis on data from the EXTRA trial (ClinicalTrials.gov Identifier: NCT00314574) a randomized placebo-controlled trial in which patients with inadequately controlled severe asthma received high-dose ICS and long-acting beta-2 agonists, with or without additional controller therapy, and were randomized to receive additional placebo or omalizumab treatment for 48 weeks. For the current post-hoc analysis, researchers assessed the use of antitussives during the treatment period for patients who received 1 or more doses of study drug therapy. Antitussives included over-the-counter or prescription medications that were narcotics or non-narcotics primarily indicated for cough symptom relief and not generally used to treat other conditions such as allergic rhinitis or sinus congestion.

During the 48-week treatment period, the researchers found that antitussive use was low overall; 85.1% (722/848) of patients did not report any use of antitussives. However, antitussive use was found to be lower for patients treated with omalizumab than with placebo, except in patients who used 3 or more antitussives.

The researchers concluded, “Despite study limitations, associated with design as an exploratory post hoc analysis and challenges in assessing antitussive use, we found that antitussive use was low overall across placebo and omalizumab groups and that omalizumab may decrease antitussive use.” This report appears to be the first of its kind examining biological therapy and antitussive use in patients with asthma.

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