Q:

11/20/2017
Patient with asthma and chronic hives. Hives responded well to xolair, asthma did not. Asthma responds well to Nucala. Can the patient be treated with both biologics simultaneously?

A:

Omalizumab and mepolizumab are biologics that have different mechanism of actions - omalizumab impact IgE and IgE receptor and mepolizumab impacting eosinophils. A recent article in JACI IP utilized both these medications to treat ABPA (http://www.jaci-inpractice.org/article/S2213-2198(17)30022-3/pdf) suggesting, at least in one patient, it appears safe to use these medications concomitantly. I suspect the challenge will be to have the insurer provide coverage for these very expensive medications.

I hope this is helpful

Andrew Murphy MD FAAAAI


 

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