Greetings. I would like to share my thoughts and some news about a new treatment for those with severe asthma.
While asthma affects over 5% of Americans, fortunately the majority of asthma sufferers have symptoms that can be controlled with inhalers and oral medications. This entry will discuss a new treatment for people with more severe asthma that works in a novel way to control airway swelling and inflammation: anti-IgE antibody (omalizumab, Xolair®)
What is omalizumab and how does it work?
Omalizumab is an antibody that attacks a patient’s circulating IgE antibody, the antibody that is elevated in many patients with asthma, and which is partly responsible for the initial phase of the allergic response leading to swelling of the airways and wheeze. By binding IgE, omalizumab prevents IgE from attaching to cells that, when they encounter allergens, release substances (including histamine) which recruit other cells, causing more inflammation in the windpipes. Since asthma symptoms are caused by different factors that contribute to inflammation in the airways, omalizumab only treats a part of the inflammation in asthma, so is not a ‘magic bullet’. Nevertheless, it is a novel approach to treating asthma since no other medication ‘attacks’ this mechanism in asthma.
Who should be considered for omalizumab?
Typically, omalizumab is considered for patients who have documented allergies to specific allergens in the environment, (such as tree pollens or house dust mites), since the medication works by minimizing the allergic response in the airways. In addition, since many current treatments for asthma are so effective, it is usually considered in patients whose asthma symptoms persist despite aggressive treatment with inhalers and oral medications, or who have frequent flares that require medical attention in their doctor’s office or emergency room. It is unlikely to be effective for patients with asthma that is triggered exclusively by exercise, cold air, or other physical factors.
How is omalizumab given?
Omalizumab is only given by subcutaneous injection (under the skin), much like allergy shots. Depending on a patient’s weight and IgE level in the blood (the antibody omalizumab is targeted at neutralizing), injections are scheduled every two or four weeks. It can take 2-3 months to see the maximum benefit, so it is crucial for patients to make all their scheduled appointments for injections.
As mentioned earlier, omalizumab is not for every patient with asthma. If you have severe asthma and your symptoms are not adequately controlled despite taking your medicines faithfully, ask you doctor about omalizumab. This novel treatment may help better control your asthma.
Published On: July 27, 2006