Ayobami Akenroye, MB ChB, MPH, PhD

Although many individuals with asthma require long term treatment with inhaled corticosteroids (ICS), and recent guidelines for asthma management have expanded the indications for ICS use, little is known about the long-term effects of ICS. It is also unclear if the use of omalizumab, a monoclonal antibody approved for asthma treatment mitigates any of the potential side effects. Using metabolomics techniques, a method that studies small molecules (metabolites) in the body, we have found that inhaled steroids cause more adrenal suppression than previously recognized. In this study, we seek to: 1) characterize any changes in metabolites over time in individuals with severe asthma on ICS; 2) characterize any changes in metabolites over time in individuals with severe asthma taking omalizumab; and 3) assess whether omalizumab slows down or reverses adrenal suppression or other changes caused by ICS use. By looking at these changes by age, sex and race/ethnicity, we may also identify subgroups that are more prone to these side effects or more likely to benefit from omalizumab.