SELECTED ARTICLES FROM THE RECENT LITERATURE 2005

10/26/05

Omalizumab – possible indications in conditions other than asthma

Summary
Background – Omalizumab (Omal), a recombinant humanized anti-IgE antibody, has been approved for the treatment of persistent allergic asthma not well controlled with inhaled corticosteroids. More recent studies of Omal have been directed to trials in other allergic diseases.

Findings – The use of Omal in non-asthma conditions was reviewed by Mankad and Burks of Duke Univ in Durham, NC. They pointed out that the interference by Omal of binding of IgE to the high affinity IgE receptor (Fc epsilon RI) would make it appropriate for a variety of diseases in which IgE antibodies play a major pathogenic role. Indeed, beneficial effects of Omal treatment have been reported in allergic rhinitis. Limited trials have shown that Omal treatment can reduce the degree of marked food allergy, so that individuals can tolerate at least small amounts of the offending food. Omal treatment has also been used as an adjunct to standard allergy immunotherapy (AIT) with encouraging results to date.

Reference
Clin Rev Allergy Immunol 2005;29:17-30

Editor's Comments
I have reviewed this report by a highly respected group in Pediatric Allergy because of their discussion of non-asthma conditions. I feel that the current sizable expense of Omal therapy will likely limit its chronic use to severe allergic diseases not controlled by other therapies. However, a possible very valuable short-term use of Omal may be in allowing more rapid allergen dosage build up in AIT in very sensitive individuals who have had repeated systemic reactions during previous attempts at AIT.

 

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