Xolair / Omalizumab

What is Xolair?

Xolair (Omalizumab) injection is a prescription medication used to treat moderate to severe persistent allergic asthma and refractory chronic idiopathic urticaria.

Omalizumab is “IgE blocker”. IgE is short for immunoglobulin E. Immunoglobulin E is a substance that occurs naturally in the body in small amounts. When patients with allergic asthma inhale an “allergen” (animal dander, dust mite etc.), their immune system makes more IgE. This may cause a chain of immune reactions that lead to asthma symptoms. Omalizumab helps by blocking IgE.

This medicine is given under the direct supervision of a physician.

Who should be considered for Xolair?

To be considered for Xolair, patient have to be 12 years or older.

For asthma, it is used when a patient’s asthma has not been controlled sufficiently on other asthma medicines (e.g. corticosteroid inhalers). To get approved for asthma, the patient should have a positive skin test to an allergen such as pollen, cat or dust.

For chronic idiopathic urticaria, it is used in patients who continue to have hives that are uncontrolled by antihistamines.

What can one expect for Xolair?

In clinical studies, many patients on Xolair reported a decrease in asthma and urticarial symptoms. Many patients were eventually able to reduce the amount of medications they were taking.

What is the course of treatment with Xolair?

A nurse or other trained health professional will give this medicine in a supervised medical setting.

Omalizumab is given as a subcutaneous shot under your skin.

For asthma, you will receive omalizumab once every 2 or 4 weeks. Your dose will be determined by your IgE level, which your doctor will measure with a simple blood test before treatment begins, and your body weight.

For chronic idiopathic urticaria, you will receive omalizumab every 4 weeks.

What are possible side effects for Xolair?

The most common side effect associated with Xolair is an injection-site reaction.

Xolair may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Symptoms include rash, cough, chest tightness, shortness of breath, trouble breathing, wheezing, lightheadedness, dizziness, fainting, rapid or weak heartbeat, anxiety, flushing, itching, hives, feeling warm, swelling of the throat or tongue, throat tightness, hoarseness, or trouble swallowing after receiving this medicine. Your doctor will ask the patient to remain in the clinic for at least 2 hours after each injection to watch for immediate side effects that can be serious. After three doses, you would be asked to remain in office for 30 mins.

A rare but serious condition called eosinophilia (increased white blood cells in the body) and vasculitis (inflammation of the blood vessels) may occur while you are receiving this medication. Tell your doctor right away if you or your child have worsening lung symptoms, rash or bruising of the skin, fever, chest pain, or burning, tingling, or numbness in the hands and feet after receiving this medicine.

In clinical studies, the incidence of cancer was 0.5% in patients receiving Xolair versus 0.2% in patients receiving placebo injections. This was not deemed to be statistically significant and the type of cancers reported were age-specific and not thought to be related to receiving treatment with Xolair.