Pharm

Omalizumab

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Omalizumab, rhuMAb-E25, Xolair

  • See Also
  1. Asthma Biologic
  2. Asthma Management
  3. Severe Asthma
  • Indications (all required)
  1. See Severe Asthma
  2. Refractory moderate to Severe Persistent Asthma
  3. Positive Allergy Testing for perennial inhaled allergen
  4. Patients must be age 6 years or older
  • Mechanism
  1. Recombinant humanized Monoclonal Antibody (rhu-MAB)
  2. Blocks IgE binding to Mast Cells and Basophils
    1. Prevents release of Allergic Reaction mediators
  • Adverse Effects
  1. Serious and life-threatening
    1. May predispose to malignancy
    2. Anaphylaxis
      1. Requires administration in clinical setting
      2. Reaction may occur within 2 hours of injection
  2. Other reactions
    1. Injection site reaction
    2. Upper Respiratory Infections (including Sinusitis, Pharyngitis)
    3. Headache
    4. Alopecia
    5. Musculoskeletal (Arthralgias, myalgias, limb pain)
  • Efficacy
  1. Reduces Asthma Exacerbations, hospitalizations and Inhaled Corticosteroid dosing in Allergic Asthma
    1. Normansell (2014) Cochrane Database Syst Rev (1):CD003559 +PMID:24414989 [PubMed]
  • Cost
  1. Dose dependent
  2. Varies from $500 to over $3000 for one month supply
  • Dosing
  1. Dose determined by serum IgE level
  2. Usually 150 to 375 mg SQ every 2-4 weeks
  3. Must be given in clinical setting with observation
  • References
  1. Finn (2003) J Allergy Clin Immunol 111:278-84 [PubMed]
  2. Raymond (2023) Am Fam Physician 107(4): 358-68 [PubMed]