Acta Pharm. 55 (2005) 123-138

Anti-IgE therapy with omalizumab in asthma and allergic rhinitis

SLAVICA DODIG^1*, DARKO RICHTER¹, IVANA CEPELAK² and  BOJAN BENKO³

slavica.dodig@zg.t-com.hr

¹Special Hospital for Respiratory Diseases in Children and Adolescents, Reference Center for Clinical Pediatric Allergology of Croatian Ministry of Health, Zagreb, Croatia
²Department of Medical Biochemistry and Hematology, Faculty of Pharmacy and Biochemistry, University of Zagreb Zagreb, Croatia
³State Intellectual Property Office, Zagreb, Croatia

The pharmacology, efficacy, dosage, adverse effects, and economics of anti IgE (omalizumab) are discussed. Omalizumab is the generic name for the human/murine chimeric (recombinant humanized) monoclonal IgG antibody. Anti-IgE prevents IgE from attaching to effector cells, and thereby blunts IgE-mediated inflammatory responses. After subcutaneous administration its absorption is slow, reaching peak concentration in serum after an average of 7-8 days. At recommended doses, serum free IgE levels decrease within 1 hour following the first dose and maintained between doses. Dose and dosing frequency are adjusted according to body mass and serum total IgE concentration before the start of treatment. Omalizumab administered subcutaneously is an effective treatment for add-on therapy in patients with poorly controlled, moderate-to-severe allergic asthma and allergic rhinitis (adults and adolescents >12 years). It reduces the requirement for inhaled corticosteroids while protecting against disease exacerbation. Omalizumab is well tolerated, but the safety profile requires long-term assessment in adults as well as in children.

Keywords: asthma, allergic rhinitis, therapy, anti-IgE, omalizumab