Time of Day Dependent Effectiveness of Anti-IgE Therapy in Asthma: Clinical and Experimental Evidence

Afternoon initiation of omalizumab in 153 asthma patients is linked to better response, with an adjusted odds ratio of 5.20 versus morning dosing.

• Why it matters: Asthma shows circadian rhythms, but it is unclear whether timing also affects advanced biologic therapy in moderate-to-severe disease.
• What they did: In a retrospective cohort, time of day was modeled continuously and dichotomized (8:00–11:59 vs 12:00–17:00) using multivariable logistic regression and Cox analyses; OVA-sensitized mice received anti-IgE at different times and lung pathology was measured.
• The result: Each hour later for the initial omalizumab dose increased response odds by 34% (adjusted OR 1.34), and in mice anti-IgE reduced OVA-driven airway hyperresponsiveness and type-2 inflammation in a time-of-day-sensitive pattern.

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