Xolair

Note: This post is mostly for my family, but I decided to put it on here as there are others out there dealing with severe persistent allergic asthma. Knowledge is power!

When I first heard about Xolair and Omalizumab, I thought they sounded like characters out of a bad sci-fi novel, not asthma therapy. My Doctor first mentioned them about four or five months ago in passing (and butchered the word omalizumab) as treatment possibilities. When it was clear by the first of June, that inhaled corticosteroids were maintaining me at a sub-par level but not helping me get better, my doctor mentioned Xolair again. I took some blood tests, submitted my allergy “scratch” test results from last year, and the results of those tests qualified me for Xolair.

Xolair is the brand name for Omalizumab treatment. Omalizumab treatment attacks the IgE levels in the blood. The body produces antibodies in response to substances it perceives as threats. One of these antibodies is IgE which releases a variety of chemicals including histamines and lukotrienes which asct as messengers in stimulating acute bronchospasms in the airways. IgE doesn’t just play a part in intital attacks, but also the cascade attacks. 4-8 hours after the initial attack and exposure to the allergen, asthmatics may have a second attack which is called the allergic cascade. IgE plays a similar role in that too.

Xolair targets and attacks the IgE, which lessens the number of attacks, and allows many on it to live more normal lives. Xolair isn’t a cure, and it isn’t without its risks. The drug is new (approved in 2006 by the FDA), but there seems to be an association between Xolair and lymphoma which makes sense because these IgE receptors also do double duty by attacking cells that can lead to lymphoma. Xolair may also lead to heart problems, but the results of that study won’t be released until next year.

Xolair is incredibly expensive. The treatment runs 10k to 30k a year, and because of that there’s certain criteria that has to be met in order to go on the shot. Xolair treatment is only considered when cortisteroids aren’t helping to make a patient better. Although we haven’t received health insurance approval yet, my blood work and allergy test results show that I qualify for the drug.

After talking to my allergist and the pulmonologist, doing research on the treatment, talking to my family and close friends about it, I came to the decision that this is what needs to be done next so I can go back to leading a more normal life. I’ll continue to be on the cortisteroids, but hopefully we’ll be able to start cutting back on those after being on xolair for a period of time. Xolair isn’t a cure, but being healthier? That sounds great.