Omalizumab and mepolizumab
Question:
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?
Answer:
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