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omalizumab

Phase 4FDA approved

Asthma | Monoclonal antibody | Respiratory |Roche Holding AG|Trials Updated: Sep 4, 2026

omalizumab development status

FDA approval on record Jun 20, 2003 as Xolair
Approval holderGenentech
ApplicationBLA103976
Highest phase Phase 4 (NCT01922037)
Phase scored for RHHBYPhase 3
Registered trials 80 across 21 sponsors since Oct 2002

Label indication XOLAIR is an anti-IgE antibody indicated for: Moderate to severe persistent asthma in adults and pediatric patients 6 years of age and older with a positive skin test or in vitro reactivity to a perennial aeroallergen and symptoms that are inadequately controlled with inhaled corticosteroids ( 1.1 ) Chronic rhinosinusitis with nasal polyps (CRSwNP) in adult patients 18 years of age and older with inadequate response… FDA label

omalizumab target and mechanism

Molecular targetIGHE
Target classInhibitor
ModalityMonoclonal antibody

Also known as Xolair (omalizumab), Xolair, omalizumab (Xolair), IGE025, RO5489789

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials14
Total Enrollment4,737

FDA Designations

No designations recorded

omalizumab clinical trials

omalizumab · 14 trials · 8 indications

Phase 3 10Phase 2 4
NCT03478930An Extension Study of Omalizumab in Participants With Chronic Rhinosinusitis With Nasal PolypsNasal Polyps
COMPLETED249 Analytics
NCT03280537A Clinical Trial of Omalizumab in Participants With Chronic Rhinosinusitus With Nasal PolypsNasal Polyps
COMPLETED127 Analytics
NCT03280550A Clinical Trial of Omalizumab in Participants With Chronic Rhinosinusitis With Nasal PolypsNasal Polyps
COMPLETED138 Analytics
NCT01292473A Study to Evaluate the Efficacy, Response Duration and Safety of Xolair (Omalizumab) in Patients With Chronic Idiopathic Urticaria (CIU)/Chronic Spontaneous Urticaria (CSU) Who Remain Symptomatic Despite Antihistamine Treatment (H1)Chronic Idiopathic Urticaria
COMPLETED323 Analytics
NCT01264939A Safety Study of Xolair (Omalizumab) in Patients With Chronic Idiopathic Urticaria (CIU) Who Remain Symptomatic Despite Treatment With H1 Antihistamines, H2 Blockers, and/or Leukotriene Receptor AntagonistsChronic Idiopathic Urticaria
COMPLETED336 Analytics
NCT01287117A Study of the Efficacy and Safety of Omalizumab (Xolair) in Patients With Chronic Idiopathic Urticaria (CIU)/Chronic Spontaneous Urticaria (CSU) Who Remain Symptomatic Despite Antihistamine (H1) TreatmentChronic Idiopathic Urticaria
COMPLETED319 Analytics
NCT00314574A Study of Omalizumab (Xolair) in Subjects With Moderate to Severe Persistent Asthma (EXTRA)Asthma
COMPLETED850 Analytics
NCT00109200A Continued Access Protocol to Provide Xolair to Patients With Severe Allergic AsthmaAsthma
COMPLETED- Analytics
NCT00109187An Extension Study of Xolair in Moderate to Severe, Persistent Asthma Patients Who Completed Study Q2143gAsthma
COMPLETED- Analytics
NCT00401596A Study to Evaluate the Safety of Xolair in Moderate to Severe Persistent Asthma Patients (ALTO)Asthma
COMPLETED1,899 Analytics
PHASE3COMPLETED
An Extension Study of Omalizumab in Participants With Chronic Rhinosinusitis With Nasal Polyps
Nasal PolypsUnlock trial analytics
PHASE3COMPLETED
A Clinical Trial of Omalizumab in Participants With Chronic Rhinosinusitus With Nasal Polyps
Nasal PolypsUnlock trial analytics
PHASE3COMPLETED
A Clinical Trial of Omalizumab in Participants With Chronic Rhinosinusitis With Nasal Polyps
Nasal PolypsUnlock trial analytics
PHASE3COMPLETED
A Study to Evaluate the Efficacy, Response Duration and Safety of Xolair (Omalizumab) in Patients With Chronic Idiopathic Urticaria (CIU)/Chronic Spontaneous Urticaria (CSU) Who Remain Symptomatic Despite Antihistamine Treatment (H1)
Chronic Idiopathic UrticariaUnlock trial analytics
PHASE3COMPLETED
A Safety Study of Xolair (Omalizumab) in Patients With Chronic Idiopathic Urticaria (CIU) Who Remain Symptomatic Despite Treatment With H1 Antihistamines, H2 Blockers, and/or Leukotriene Receptor Antagonists
Chronic Idiopathic UrticariaUnlock trial analytics
PHASE3COMPLETED
A Study of the Efficacy and Safety of Omalizumab (Xolair) in Patients With Chronic Idiopathic Urticaria (CIU)/Chronic Spontaneous Urticaria (CSU) Who Remain Symptomatic Despite Antihistamine (H1) Treatment
Chronic Idiopathic UrticariaUnlock trial analytics
PHASE3COMPLETED
A Study of Omalizumab (Xolair) in Subjects With Moderate to Severe Persistent Asthma (EXTRA)
AsthmaUnlock trial analytics
PHASE3COMPLETED
A Continued Access Protocol to Provide Xolair to Patients With Severe Allergic Asthma
AsthmaUnlock trial analytics
PHASE3COMPLETED
An Extension Study of Xolair in Moderate to Severe, Persistent Asthma Patients Who Completed Study Q2143g
AsthmaUnlock trial analytics
PHASE3COMPLETED
A Study to Evaluate the Safety of Xolair in Moderate to Severe Persistent Asthma Patients (ALTO)
AsthmaUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Baseline in Nasal Polyp Score (NPS)
Baseline, Weeks 4, 8, 16, 24, 36, 52, 64, and 76

Total NPS ranges from 0 to 8 (sum of 0-4 for left and right nasal passage scores per the following criteria), with a lower score indicating smaller-sized nasal polyps: 0 = No polyps; 1 = Small polyps in the middle meatus not reaching below the inferior border of the middle turbinate; 2 = Polyps reaching below the lower border of the middle turbinate (modified to accommodate those with a middle turbinectomy, such that polyp must have reached the top of the inferior turbinate.); 3 = Large polyps reaching the lower border of the inferior turbinate or polyps medial to the middle turbinate; and 4 = Large polyps causing complete obstruction of the inferior nasal cavity. Two blinded primary independent expert readers reviewed every post-screening recorded video endoscopy for a given participant to determine total NPS. A third reader chose one of the two scores to be used for analysis in cases where there was any discrepancy in total NPS assigned between the two primary readers.

Change From Baseline in Average Daily Nasal Congestion Score (NCS)
Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, and 76

The Nasal Congestion Score (NCS) was assessed daily by the participant via an electronic diary as the response to the following question: Is your nose blocked? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0 = Not at all; 1 = Mild; 2 = Moderate; and 3 = Severe. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

Percentage of Participants With Adverse Events (AE) and Serious Adverse Events (SAE)
From Start to End (Weeks 24 to 52) of OLE Study

A serious adverse event was defined as any adverse event that met any of the following criteria: was fatal; was life-threatening; required or prolonged inpatient hospitalization; resulted in persistent or significant disability/incapacity; was a congenital anomaly/birth defect in a neonate/infant born to a mother exposed to the study drug; or, was a significant medical event in the investigator's judgment. Multiple occurrences of the same serious adverse event in one individual were counted once.

Percentage of Participants With Adverse Events Leading to Discontinuation of Omalizumab
From Start to End (Weeks 24 to 76) of OLE Study

A serious adverse event was defined as any adverse event that met any of the following criteria: was fatal; was life-threatening; required or prolonged inpatient hospitalization; resulted in persistent or significant disability/incapacity; was a congenital anomaly/birth defect in a neonate/infant born to a mother exposed to the study drug; or, was a significant medical event in the investigator's judgment. Multiple occurrences of the same serious adverse event in one individual were counted once.

Change From Baseline in Nasal Polyp Score (NPS) at Week 24
Baseline, Week 24

Total NPS ranges from 0 to 8 (sum of 0-4 for left and right nasal passage scores per the following criteria), with a lower score indicating smaller-sized nasal polyps: 0 = No polyps; 1 = Small polyps in the middle meatus not reaching below the inferior border of the middle turbinate; 2 = Polyps reaching below the lower border of the middle turbinate (modified to accommodate those with a middle turbinectomy, such that polyp must have reached the top of the inferior turbinate.); 3 = Large polyps reaching the lower border of the inferior turbinate or polyps medial to the middle turbinate; and 4 = Large polyps causing complete obstruction of the inferior nasal cavity. Two blinded primary independent expert readers reviewed every post-screening recorded video endoscopy for a given participant to determine total NPS. A third reader chose one of the two scores to be used for analysis in cases where there was any discrepancy in total NPS assigned between the two primary readers.

Change From Baseline in Average Daily Nasal Congestion Score (NCS) at Week 24
Baseline, Week 24 (Study Days 155 to 186)

The Nasal Congestion Score (NCS) was assessed daily by the participant via an electronic diary as the response to the following question: Is your nose blocked? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0 = Not at all; 1 = Mild; 2 = Moderate; and 3 = Severe. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.

Change From Baseline in the Weekly Itch Severity Score at Week 12
Baseline, Week 12

The weekly itch severity score is the sum of the daily itch severity scores over 7 days and ranges from 0 to 21. The daily itch severity score is the average of the morning and evening scores on a scale of 0 (none) to 3 (severe). The Baseline weekly itch severity score is the sum of the daily itch severity scores over the 7 days prior to the first treatment. A higher itch severity score indicates more severe itching. A negative change score indicates improvement.

Percentage of Participants With Adverse Events
Baseline to the end of study (up to 40 weeks)

The percentage of participants with serious adverse events and other adverse events is summarized by MedDRA preferred terms and organ classes in the Reported Adverse Events section below.

Change From Baseline to Week 12 in the Weekly Itch Severity Score
Baseline to Week 12

The weekly itch severity score is the sum of the daily itch severity scores over 7 days and ranges from 0 to 21. The daily itch severity score is the average of the morning and evening scores on a scale of 0 (none) to 3 (severe). The Baseline weekly itch severity score is the sum of the daily itch severity scores over the 7 days prior to the first treatment. A higher itch severity score indicates more severe itching. A negative change score indicates improvement.

Rate of Asthma Exacerbations Over the 48 Week Treatment Period
48 weeks

A protocol-defined asthma exacerbation was defined as worsening of asthma symptoms requiring treatment with systemic corticosteroids for 3 or more days; for patients receiving long-term oral corticosteroids, an exacerbation was a 20 mg or more increase in average daily dose of oral prednisone (or a similar dose of another systemic corticosteroid). The rate of protocol-defined asthma exacerbations, normalized by subject-time at risk and computed over the 48 week treatment period in each treatment group.

Incidence of all serious adverse events.
Rate of COPD exacerbations
12 months

To determine the efficacy of omalizumab injection in reducing the annualized rate of moderate or severe exacerbations (primary outcome) over the course of 12 months among individuals with COPD having sensitization and exposure to any of a panel of common indoor aeroallergens.

Change in Urticaria Activity Score 7 (UAS7) From Baseline to Week 4
Baseline (based on the 7 days prior to randomization) and 4 weeks (Days 21-27)

The UAS is a composite diary-recorded score, which is the sum of the numeric severity intensity ratings (0 = none to 3 = intense) for 1) the number of wheals (hives) and 2) the intensity of the pruritus (itch). The UAS7 is the sum of the daily average UAS (morning and evening values) for 7 days. The maximum UAS7 score is 42.

Change in Logarithmically Transformed (log2) Allergen PC15 Concentration (Allergen Concentration Required to Evoke a 15% Decrease in FEV1)
From baseline to Week 16

The primary analysis included two tests: a test for superiority of the lyophilized formulation of omalizumab compared with placebo in the change of allergen concentration and a test for the superiority of the aged liquid omalizumab compared with placebo. The difference for the change in the allergen concentration between the lyophilized formulation of omalizumab and placebo, and between the aged liquid omalizumab and placebo were assessed by the exact Wilcoxon-Mann-Whitney test.

Serious Adverse Events
Through Week 52

All grades according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), v3.0. An SAE is defined as an adverse event that results in death, is life threatening, requires hospitalization, results in significant disability, results in birth defect, or is considered a significant medical event by the investigator

Secondary Endpoints

Change From Baseline in Average Daily Total Nasal Symptom Score (TNSS)
Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, and 76
Change From Baseline in Loss of Sense of Smell Score
Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, and 76
Change From Baseline in Average Daily Posterior Rhinorrhea Score
Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, and 76
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Cohort A: Study GA39688 OmalizumabEXPERIMENTALParticipants who received omalizumab once every 2 weeks (Q2W) or once every 4 weeks (Q4W) in Study GA39688 will continue to receive omalizumab at Week 24 at the same dosing schedule.
Cohort A: Study GA39688 PlaceboEXPERIMENTALParticipants who received placebo Q2W or Q4W in Study GA39688 will start receiving omalizumab Q2W or Q4W at Week 24 at the same dosing schedule.
Cohort B: Study GA39855 OmalizumabEXPERIMENTALParticipants who received omalizumab Q2W or Q4W in Study GA39855 will continue to receive omalizumab at Week 24 at the same dosing schedule.
Cohort B: Study GA39855 PlaceboEXPERIMENTALParticipants who received placebo Q2W or Q4W in Study GA39855 will start receiving omalizumab Q2W or Q4W at Week 24 at the same dosing schedule.
OmalizumabEXPERIMENTALParticipants received omalizumab as a subcutaneous injection once every 2 weeks (q2w) or once every 4 weeks (q4w). The dose (from 75 mg up to 600 mg) and dosing frequency (q2w or q4w) was determined by serum total IgE level and body weight using the study-drug dosing table. All participants were also treated during the entire study with intranasal corticosteroids (mometasone nasal spray) as background therapy.
PlaceboPLACEBO_COMPARATORParticipants received matching placebo as a subcutaneous injection once every 2 weeks or once every 4 weeks. The dose and dosing frequency was determined by serum total IgE level and body weight using the study-drug dosing table. All participants were also treated during the entire study with intranasal corticosteroids (mometasone nasal spray) as background therapy.
Omalizumab 75 mgEXPERIMENTALOmalizumab 75 mg sc every 4 weeks
Omalizumab 150 mgEXPERIMENTALOmalizumab 150 mg sc every 4 weeks
Omalizumab 300 mgEXPERIMENTALOmalizumab 300 mg sc every 4 weeks.
XolairEXPERIMENTALThe subcutaneous dose of Xolair administered in this study was either a minimum of 0.008 mg/kg/IgE (IU/mL) every 2 weeks or a minimum of 0.016 mg/kg/IgE (IU/mL) every 4 weeks for 48 weeks. Participants maintained their high-dose inhaled corticosteroid (minimum of 500 µg of fluticasone dry powder inhaler twice a day or its ex-valve equivalent) and Long-Acting Beta-Agonist dose (either 50 µg salmeterol twice daily or 12 µg formoterol twice daily) throughout the study. Participants were permitted to use albuterol as rescue medicine throughout the study.
Omalizumab injectionACTIVE_COMPARATORActive treatment is omalizumab injection, dosed using standardized weight and total IgE based table, as used for asthma treatment
Placebo injectionPLACEBO_COMPARATORPlacebo for omalizumab used in the study will be commercially packaged 0.9% Sodium Chloride Injection, USP (e.g., normal saline). The injection volumes of normal saline administered will be calculated based upon the volume of active omalizumab expected to be administered based upon weight and total IgE level.
Omalizumab 600 mgEXPERIMENTALOmalizumab (Xolair) was administered subcutaneously on Day 0 of the study. Participants remained on stable doses of their pre-allocation Chronic Idiopathic Urticaria (CIU) H1 antihistamine treatment throughout the study, and were provided diphenhydramine as rescue medication for pruritus relief on an as-needed basis.
1EXPERIMENTAL -
2EXPERIMENTAL -
3PLACEBO_COMPARATOR -

Interventions

NameTypeDescription
OmalizumabDRUGOmalizumab will be administered as a subcutaneous (SC) injection Q2W or Q4W.
PlaceboDRUGParticipants will not be receiving placebo in this OLE study. Participants who were randomized to the placebo arms for 24 weeks in studies GA39688/GA39855 and then enter this OLE study will receive omalizumab, but they will be placed in separate analysis cohorts.
H1 antihistamine, H2 antihistamine, leukotriene receptor antagonistDRUGParticipants were required to maintain stable doses of their pre-randomization combination therapy with an H1 antihistamine and either an H2 blocker or leukotriene receptor antagonist, or all 3 drugs in combination, throughout the 24-week treatment period and 16-week follow-up period of the 40-week study.
DiphenhydramineDRUGParticipants were provided with diphenhydramine 25 mg for itch relief on an as-needed basis, up to a maximum of 3 doses within 24 hours for the duration of the 40-week study.
omalizumab (Xolair)DRUGOmalizumab (Xolair) was administered by subcutaneous (SC) injection every 2 or 4 weeks. Xolair was supplied as a sterile, white, preservative-free, lyophilized powder in single-use vials that were reconstituted with Sterile Water for Injection (SWFI), USP.
corticosteroidsDRUGMinimum dose of 500 µg of fluticasone dry-powder inhaler or its equivalent ex-valve dose twice a day.
long-acting beta-agonistsDRUG50 µg salmeterol twice daily or 12 µg formoterol twice daily.
Xolair (omalizumab)DRUG -
Omalizumab (Xolair®)DRUGThe study drug (omalizumab or placebo) will be given as a subcutaneous injection, which means an injection into the fat layer just under the skin in your arm or leg. This is similar to an insulin injection and not as deep as a typical vaccine injection. After the injection, participants will be monitored for any side effects. The study team will determine the dose and how often the injection is given based on the participant's weight and blood test results. Injections will be either be given monthly, 12 doses, or twice per month, 24 doses. All injections will be given at the clinic.
Sodium Chloride (NaCl) 0.9 %DRUGThe study drug (omalizumab or placebo) will be given as a subcutaneous injection, which means an injection into the fat layer just under the skin in your arm or leg. This is similar to an insulin injection and not as deep as a typical vaccine injection. After the injection, participants will be monitored for any side effects. The study team will determine the dose and how often the injection is given based on the participant's weight and blood test results. Injections will be either be given monthly, 12 doses, or twice per month, 24 doses. All injections will be given at the clinic.
H1 antihistaminesDRUGPatients received one of the following: Cetirizine 10 mg once per day (QD), Levocetirizine dihydrochloride 5 mg QD, Fexofenadine 60 mg twice per day or 180 mg QD, Loratadine 10 mg QD or Desloratadine 5 mg QD
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Eligibility Criteria

Age Range18 Years to 75 Years
SexALL
Healthy VolunteersNo
Study Sites79

Inclusion Criteria: * Ability to comply with the study protocol, in the investigator's judgment * Participation in Study GA39688 or GA39855, including completion of endoscopy and other assessments at Week 24, without discontinuation of study drug * Completion of eDiary daily assessments for at leas...

Countries:United StatesBelgiumCanadaCzechiaFranceGermanyHungaryMexicoPolandPortugalRussiaSpainUkraineUnited KingdomFinlandDenmarkItalyTurkey (Türkiye)AustraliaNew ZealandSingaporeSwitzerland
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Frequently asked questions about omalizumab

What is omalizumab used for?

Omalizumab is studied in allergic asthma, chronic idiopathic urticaria, chronic obstructive pulmonary disease (COPD), nasal polyps, and peanut hypersensitivity. It is a monoclonal antibody developed by Roche Holding AG under the ticker RHHBY. The program is in Phase 2 development, and the clinical trials listed focus on COPD and chronic rhinosinusitis with nasal polyps.

What does omalizumab target?

Omalizumab targets IGHE, immunoglobulin E, and acts as an inhibitor of that target. By binding immunoglobulin E, the monoclonal antibody is designed to interfere with the IgE pathway that drives allergic responses. This mechanism underlies its study across allergic asthma, chronic idiopathic urticaria, nasal polyps, COPD, and peanut hypersensitivity.

Who makes omalizumab?

Omalizumab is developed by Roche Holding AG, which trades under the ticker RHHBY. Roche is the company associated with the omalizumab program across its studied indications, including allergic asthma, chronic idiopathic urticaria, COPD, nasal polyps, and peanut hypersensitivity.

What phase is omalizumab in?

Omalizumab is in Phase 2 development. It is an investigational monoclonal antibody and is not described as approved. The program has four completed trials and one active trial, with a total enrollment of 2,749 participants across randomized, double-blind, placebo-controlled studies.

What clinical trials is omalizumab in?

The active study is NCT07059091, a Phase 2 trial of omalizumab in allergen sensitized and exposed individuals with COPD, recruiting 334 participants in the United States. Completed trials include NCT03478930, NCT03280550, and NCT03280537, all Phase 3 studies in chronic rhinosinusitis with nasal polyps.

Is omalizumab the same as Xolair?

Yes, omalizumab is also known as Xolair. The names Xolair, Xolair (omalizumab), omalizumab (Xolair), and Omalizumab (Xolair) all refer to the same monoclonal antibody developed by Roche Holding AG. Searches for any of these names point to the same Phase 2 program.