Omalizumab for Asthma

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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. This medicine costs a lot more than any of the standard treatments for asthma.

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

This medicine may help reduce asthma episodes, improve peak expiratory flow (PEF) , and reduce the need for other medicines. It may also reduce emergency room visits and hospital stays. But more study is needed.

Omalizumab is given as a shot. The dose depends on your 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 corticosteroids or who need high doses of inhaled corticosteroids for daily control can also consider using this medicine.
  • You have severe allergic asthma and your symptoms aren't relieved by avoiding allergens or taking other medicines.

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


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.


ByHealthwise Staff

Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine

Specialist Medical Reviewer Rohit K Katial, MD - Allergy and Immunology

Current as ofAugust 21, 2015