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Table 4 Presumed mechanisms of action of Omalizumab and effects in asthma

From: Severe asthma and the omalizumab option

Immunological Effects  
Direct effects Binding to constant region of IgE
  Decreased free levels of IgE
  Decreased mast cell/basophil FcεR1 expression
Indirect effects Decreased mucosal eosinophils
  Decreased sputum eosinophils
  Decreased tissue IgE+ mast cells
  Decreased tissue B and T lymphocytes
  Inhibition of early and late phase reactions
  Improved BHR/unchanged BHR
  Improved response to methacholine challenge
  Mast cell stabilization: inhibits degranulation
Clinical Effects  
Effects on asthma Decreased exacerbations
  Improved peak flow
  Small improvement in FEV1
  Decreased rescue β2-agonist use
  Improved quality of life
  Decreased mean nocturnal clinical score
  Decreased total asthma clinical score
  Decreased hospitalizations
  Improved asthma control
  Steroid-sparing effect