Effects of Omalizumab(Xolair) an Anti-IgE Treatment on Severe Persistent Allergic Asthma when Uncontrolled by Corticosteroids
MacDonald, Scott A.
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Omalizumab(Xolair) is a monoclonal antibody targeted to form complexes with free immunoglobulin E (lgE). This drug is administered to patients with severe persistent asthma that is uncontrolled with inhaled corticosteroids or oral corticosteroids. lgE plays a central role in the inflammatory cascade of allergic asthma. Allergic patients have excess amounts of lgE which attach to receptors on mast cells when allergens are present. The lgE creates a cross link between the allergen and the mast cell. The mast cells degranulate when lgE is attached and release histamines and leukotrienes which initiate the inflammation symptoms throughout the airways. The purpose of omalizumab is to attach to the free lgE before it is able to find the allergens or the receptors on the mast cells. This interrupts the process and reduces the severity of the inflammation in the airway due to allergens. Studies have shown significant data suggesting that omalizumab reduces the amount of asthma exacerbations, emergency room visits, hospital stays, and unscheduled doctor visits. This anti-IgE treatment has proven useful for the small percentage of patients whose asthma is not well controlled with steroids. Anti-IgE treatment was found to be cost-effective in most cases. The drug is highly expensive but it eliminates significant amounts of emergency room and hospital bills within asthma and allergy health care. Omalizumab is also being tested in other areas of allergy and asthma that have related lgE mediated symptoms. Omalizumab is a revolutionary drug in the asthma and allergy field and has provided many patients with relief from severe allergic asthma who previously had no answers.