Pharmacodynamics of omalizumab: implications for optimised dosing strategies and clinical efficacy in the treatment of allergic asthma
- 1 January 2003
- journal article
- Published by Taylor & Francis Ltd in Current Medical Research and Opinion
- Vol. 19 (6), 491-499
- https://doi.org/10.1185/030079903125002171
Abstract
Objective: Omalizumab (Xolair ), is a recombinant humanised monoclonal anti-immunoglobulin E (IgE) antibody, for the treatment of allergic asthma. This review describes how the correlation between clinical outcomes and a suitable surrogate marker (free serum IgE) led to the development of an individualised dosing strategy for omalizumab. It also demonstrates how subsequent studies using this dosing strategy were able to achieve low levels of IgE and clinical benefit. Data sources: Published articles and data on file (Novartis PharmaAG, Genentech). Results: Studies in patients with IgE-mediated diseases of the airways have shown that clinical benefit with omalizumab is observed when free IgE levels in serum are reduced to 50ng/ml (20.8 IU ml−1) or less (target 25 ng ml−1 (10.4IU ml−1)). The ability of omalizumab to reduce free IgE levels to such levels is dependent on dose, the patient's weight and baseline IgE level. To simplify dosing, and ensure that free IgE reduction is achieved, an individualised tiered dosing table was developed from which patients with asthma, depending on weight and starting IgE level, receive omalizumab 150–375 mg by subcutaneous injection every 2 or 4 weeks. This dosing strategy has proved clinically efficacious for improving disease control in patients with allergic asthma, as shown by significantly lower exacerbation rates and decreased dependence on treatment with inhaled corticosteroids, along with improvements in symptoms, lung function and usage of rescue bronchodilators. Conclusions: The clinical efficacy of omalizumab has been optimised through the development of an individualised dosing table that emerged from an understanding of the pharmacodynamics of this agent.Keywords
This publication has 16 references indexed in Scilit:
- Omalizumab, anti-IgE recombinant humanized monoclonal antibody, for the treatment of severe allergic asthmaJournal of Allergy and Clinical Immunology, 2001
- Molecular and cellular mechanisms of allergic diseaseJournal of Allergy and Clinical Immunology, 2001
- The health economics of asthma and rhinitis. I. Assessing the economic impactJournal of Allergy and Clinical Immunology, 2001
- Total serum IgE and its association with asthma symptoms and allergic sensitization among childrenJournal of Allergy and Clinical Immunology, 1999
- IgE Inhibition as a Therapy for Allergic DiseaseInternational Archives of Allergy and Immunology, 1999
- Use of an anti-IgE humanized monoclonal antibody in ragweed-induced allergic rhinitisJournal of Allergy and Clinical Immunology, 1997
- Abnormally short serum half‐lives of IgG in β2‐microglobulin‐deficient miceEuropean Journal of Immunology, 1996
- Characterization of Complex Formation by Humanized Anti-IgE Monoclonal Antibody and Monoclonal Human IgEBiochemistry, 1995
- Inhibition of Allergic Reactions with Antibodies to IgEInternational Archives of Allergy and Immunology, 1995
- Association of Asthma with Serum IgE Levels and Skin-Test Reactivity to AllergensThe New England Journal of Medicine, 1989