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Omalizumab for Asthma

Topic Overview

Omalizumab (Xolair) is a medicine approved by the U.S. Food and Drug Administration (FDA) for use in people age 12 and older who have moderate or severe persistent asthma. Omalizumab is much more expensive than any of the conventional treatments for asthma.

Omalizumab works by blocking immunoglobulin E (IgE) from attaching to allergens. When IgE attaches to an allergen, it sets off a process that eventually leads to the symptoms of an allergic reaction.

Omalizumab may help reduce asthma episodes, improve peak expiratory flow (PEF), reduce the need for other medicines, and reduce emergency room visits and hospitalizations. But more study is needed.

Omalizumab is injected, and the dose is determined by a person's body weight and IgE level.

Your doctor may recommend this medicine if:

  • Your asthma is not well controlled after using inhaled corticosteroids and long-acting beta2-agonists or leukotriene pathway modifiers for 3 months. People who use oral or injected (systemic) corticosteroids or who require high doses of inhaled corticosteroids for daily control can also consider using omalizumab.
  • You have severe allergic asthma and your symptoms aren't relieved by avoiding allergens or taking other medicines.

Severe allergic reactions, including anaphylaxis, are possible when taking omalizumab, but this is rare. So people who get omalizumab are watched for 2 hours after they receive their first 2 doses. They should also carry epinephrine in case they have an allergic reaction after omalizumab treatment.

References

Other Works Consulted

  • Chung KF, et al. (2014). International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. European Respiratory Journal, 43(2): 343–373. DOI: 10.1183/09031936.00202013. Accessed March 11, 2014.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Rohit K Katial, MD - Allergy and Immunology
Current as of April 16, 2014

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