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Omalizumab in the treatment of allergy and asthma
Bob Lanier and Warner CarrOmalizumab (Xolair®, Novartis) is the first biologic agent introduced to specifically manage allergic disease. It is a recombinant DNA-derived humanized monoclonal immunogobulin (Ig)G1 antibody with unique antihuman IgE binding specificities. Dosed every 2 to 4 weeks subcutaneously, it has the ability to neutralize free IgE in the blood and interstitial space in less than a day. It almost completely downregulates the high-affinity IgE receptors on basophils and mast cells over a period of several weeks. In multiple Phase II and III clinical studies, omalizumab has been shown to be safe and efficacious for treating allergic asthma and has been approved in Australia and the USA for this indication. It has proven effective in allergic rhinitis, latex sensitivity and peanut sensitivity and may be used in combination with standard allergy immunotherapy, providing a safer and more efficacious approach. Numerous clinical studies are in progress evaluating its use beyond allergic asthma.