Snapshot Introduction One of 7 medications used for asthma aimed to reduce inflammation and obstruction corticosteroids β-agonists muscarinic agonists methylxanthines cromolyn antileukotrienes omalizumab Omalizumab Mechanism of action monoclonal antibody against IgE binds and inhibits free serum IgE IgE is involved in bronchoconstriction and recruitment of inflammatory cells to combat allergens therefore, omalizumab lessens these responses Clinical uses moderate-to-severe persistent asthma symptoms must be inadequately controlled on inhaled corticosteroids must have IgE-mediated allergy to at least 1 year-round allergen, proven by allergen skin test must have elevated serum IgE levels chronic idiopathic urticaria Adverse effects hypersensitivity reactions local injection site reactions urticaria anaphylaxis 1-2 out of 1000 serum sickness-like reaction very rare, only case reports treatment discontinue omalizumab and give antihistamines glucocorticoids for severe symptoms