Use of Omalizumab in Patient With Severe Atopic Asthma
I have a 29-year-old female patient with a long history of atopic asthma. She is (thankfully) recovering from a near-fatal asthma attack with respiratory failure, steroid myopathy, and acute renal failure. While in the hospital, the IgE level was measured at 14 IU/mL. Skin tests show extreme reactivity to indigenous pollens, dust mites, and animals. Is she, nevertheless, a candidate for Xolair?
David Bilstrom, MD
Treating moderate to severe persistent asthma with an Ig E-mediated component has been studied in patients with IgE levels of 30 to 700 IU/mL. Patients with IgE levels less than 30 IU/mL have not been systematically studied thus far. However, I believe that this patient may be a candidate for omalizumab (Xolair--Genentech). I would recommend applying for approval for omalizumab and using a dose based on the patient's body weight and a total IgE level of 30 IU/mL.
I have a 29-year-old female patient with a long history of atopic asthma. She is (thankfully) recovering from a near-fatal asthma attack with respiratory failure, steroid myopathy, and acute renal failure. While in the hospital, the IgE level was measured at 14 IU/mL. Skin tests show extreme reactivity to indigenous pollens, dust mites, and animals. Is she, nevertheless, a candidate for Xolair?
David Bilstrom, MD
Treating moderate to severe persistent asthma with an Ig E-mediated component has been studied in patients with IgE levels of 30 to 700 IU/mL. Patients with IgE levels less than 30 IU/mL have not been systematically studied thus far. However, I believe that this patient may be a candidate for omalizumab (Xolair--Genentech). I would recommend applying for approval for omalizumab and using a dose based on the patient's body weight and a total IgE level of 30 IU/mL.
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