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Severe Asthma — RACP Paediatrics MCQ

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HardRespiratorySevere AsthmaRACP Paediatrics

A 15-year-old boy with severe persistent asthma is on high-dose ICS/LABA, oral montelukast, and has had 4 oral corticosteroid courses in the past year. His total IgE is 450 IU/mL and he is sensitised to house dust mite. Which biologic therapy would be most appropriate to consider?

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Correct answer: D — Omalizumab

Omalizumab (anti-IgE) is PBS-listed in Australia for children ≥6 years with severe allergic asthma uncontrolled on high-dose ICS/LABA, with elevated total IgE (30–1500 IU/mL) and evidence of sensitisation to a perennial aeroallergen. It is the biologic with the most extensive paediatric data and is first-line in severe allergic asthma in children.

Reference: National Asthma Council Australia – 2024 – Australian Asthma Handbook