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Xolair (Omalizumab)

At the 3rd injection of Xolair, the result obtained is very encouraging. What is the expected benefit at the end of treatment (6 months)?
Aspergillus IgE is 800.

This medicinal product, whose international non-proprietary name (INN) is Omalizumab, is a monoclonal antibody indicated in severe asthma with positive skin tests at a per-annual pneumallergen which despite daily high dose inhaled corticosteroid treatment and an inhaled bronchodilator (Beta 2 agonist) have a FEV1 lower than 80%, diurnal symptoms or frequent nocturnal wakefulness and severe and documented exacerbations of asthma. These conditions may be present in patients with elevated serum IgE associated with allergic asthma or cystic fibrosis with allergic bronchopulmonary aspergillosis (ABPA).

The expected benefit is a decrease in exacerbations with bronchospasm, a decrease in the need for hospitalization and the possibility of reducing doses of corticosteroids. Treatment is generally accompanied by a decrease in the number of eosinophilic white blood cells if initially elevated and decreased skin reactions to allergens. The monitoring of IgE under treatment is not necessary because the levels remain high or even increase due to the formation of immune complexes IgE-Omalizumab.

The duration of the treatment is not defined: it is stopped after 6 months maximum if the patient is not "responder". Otherwise it can be continued as a chronic treatment.
It is an exceptional medicine subject to initial hospital prescription annually by a specialist, pneumologist or pediatrician. The marketing authorization (AMM) was granted in October 2005 for patients aged 12 and over and extended to children aged six and over in July 2009.

Hope this answer can help.
Best wishes
Gilles RAULT, MD, Roscoff CF Center