Use omalizumab only within trials
Omalizumab should only be used in the context of clinical trials, according to the latest edition of the Drug and Therapeutics Bulletin (2006;44:86).
The monoclonal antibody to IgE is licensed for use as add-on therapy
in severe persistent asthma with an allergic component but DTB says that
questions remain over the drug’s efficacy in preventing exacerbations,
hospital admissions and oral corticosteroid use, as well as its cost-effectiveness.
Ike Iheanacho, editor of the DTB, commented: “The annual cost of
omalizumab ranges from around £3,000 to £20,000 — excluding
the cost of a health care professional preparing and giving the injections.
“However, in the key published study that has assessed its effectiveness
in patients with severe asthma, omalizumab provided, at best, only a
marginal reduction in the rate of asthma exacerbations.”
The Scottish Medicines Consortium recommended earlier this year that
omalizumab should not
be used within NHS Scotland (PJ, 17 June, p708).
The National Institute for Health and Clinical Excellence expects to
publish guidance on omalizumab in February 2008.
Rheumatoid arthritis The DTB also reviews the use of combination therapy for management
of rheumatoid arthritis. It concludes that there is little evidence
that patients with early rheumatoid arthritis should receive tumour necrosis
factor antagonists before trying conventional disease modifying antirheumatic
drugs (ibid, p81). |
|
The
Pharmaceutical Journal
Acrobat
Reader