Immunotherapy May Ward Off Fall Asthma Attacks in Predisposed Children

Stephen J. Teach, MD, MPH Chair, Department of Pediatrics Children's National Health System Washington, DC

Dr. Stephen Teach Interview with:
Stephen J. Teach
Chair, Department of Pediatrics
Children’s National Health System
Washington, DC 

Medical Research: What is the background for this study? What are the main findings?

Dr. Teach: Inner-city children aged 6 to 17 years with moderate to severe asthma continue to experience exacerbations at high rates during the fall season despite therapy which follows the guidelines of the National Institutes of Health. These exacerbations are most common among children with a history of prior exacerbations and sensitivities to common indoor allergens who develop an upper respiratory infection with the common cold virus (rhinovirus). The PROSE study found that treatment with omalizumab begun 4 to 6 weeks before the children return to school, significantly reduced exacerbations of asthma in the first 90 days of the school year. This effect was most dramatic among those children who had experienced an exacerbation in the months preceding the beginning of the school year. Omalizumab is an antibody which binds and deactivates the IgE antibody. The IgE antibody serves as the basis for allergic sensitivity.

Medical Research: What should clinicians and patients take away from your report?

Dr. Teach: Omalizumab therapy is effective in reducing the rate of fall-related exacerbations of asthma among a subgroup of at- risk children and adolescents. The PROSE study is an example of how research can develop personalized therapies for specific “phenotypes” of children and adolescents with asthma. A phenotype is a group of patients defined by certain clinical and laboratory characteristics.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Teach: One of the important observations of the PROSE study was that the effect of omalizumab may be mediated in part by a restoration of the body’s ability to fight off infections with rhinovirus. This observation merits further study because it may suggest additional ways that asthma exacerbations can be further reduced.


Preseasonal treatment with either omalizumab or an inhaled corticosteroid boost to prevent fall asthma exacerbations

Teach, Stephen J. et al.

Journal of Allergy and Clinical Immunology October 27, 2015

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Stephen J. Teach, MD, MPH (2015). Immunotherapy May Ward Off Fall Asthma Attacks in Predisposed Children