New subcutaneous treatment for asthma launched
Omalizumab (Xolair), an anti-IgE antibody, has been launched in the UK as an add-on therapy for the treatment of asthma.
Omalizumab is indicated for adults and adolescents with severe, persistent
allergic asthma who have a positive skin test or in vitro reactivity
to a perennial aeroallergen and who have reduced lung function, as well
as frequent daytime symptoms or night-time awakenings, and who have documented
severe asthma exacerbations despite daily high-dose inhaled corticosteroids,
plus a long-acting inhaled beta2-agonist. It should only be considered
for patients with convincing IgE-mediated asthma. It is administered
by subcutaneous injection every two to four weeks. Dose and frequency
are calculated
according to baseline IgE levels and body weight.
Omalizumab was originally expected to be launched in 2001, but its launch
was delayed after regulatory agencies requested more information (PJ,
4 August 2001, p144).
Hannah George, respiratory specialist pharmacist at Royal Liverpool University
Hospital NHS Trust, commented: “Omalizumab is an exciting new immunotherapy
likely to be used at step 4 or 5 of the British Thoracic Society/Scottish
Intercollegiate Guidelines Network asthma
treatment guidelines. There
is specific criteria for treatment, which will limit its use to a relatively
small group of asthma patients. These patients will usually be under
the care of a specialist and will be reviewed regularly in the clinic
setting where this treatment could be administered and monitored. Acquisition
cost is high but this may be offset by reductions in exacerbations and
hospitalisations as seen in studies plus its use will be limited by the
specific licensed indication.”
An updated version of the BTS/SIGN guidelines has been published this
week. Regarding omalizumab, it states: “Omalizumab may be of benefit
in highly selected patients with severe persistent allergic asthma, but
at present its role in the stepwise management of asthma is unclear.” The
full updated guideline can be accessed via www.sign.ac.uk
Notice-board, p571 |
The
Pharmaceutical Journal
Acrobat
Reader