Prescribing information

 

Key criteria to help guide treatment decisions in SAA.

Xolair (omalizumab) is recommended as first choice in severe allergic asthma in appropriate patients in the UK.1,2

A roundtable discussion at the annual meeting of the Respiratory Effectiveness Group (REG) recommended that “if a patient is eligible for either an anti-eosinophilic or anti-IgE biological, the anti-IgE agent might be prioritised” for reasons including:1

  • 16-week opportunity to evaluate effectiveness
  • Response independent of eosinophil levels
  • Well-characterised safety profile with over 1 million patient-years of experience

This is further supported in the 2020 review by Viswanathan and Busse which looks at the considerations required for biologic selection:2

 

Flow diagram representing the considerations required for biological selection to help guide treatment decisions in SAA.

Adapted from Viswanathan RK and Busse WW, 2020 and the Xolair Summary of Product Characteristics, 2020.

 

*Xolair provides clinically meaningful improvements in quality of life for patients with severe allergic asthma.4
However, relative efficacy in reduction of exacerbations, OCS sparing effect and prevalent phenotype can alternatively be considered.1

Indication:4
Adults and adolescents (12 years of age and older):
Xolair is indicated as add-on therapy to improve asthma control in patients with severe persistent allergic asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen and who have reduced lung function (FEV1 <80%) as well as frequent daytime symptoms or night-time awakenings and who have had multiple documented severe asthma exacerbations despite daily high-dose inhaled corticosteroids, plus a long-acting inhaled beta2-agonist.
Children (6 to <12 years of age): Xolair is indicated as add-on therapy to improve asthma control in patients with severe persistent allergic asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen and frequent daytime symptoms or night-time awakenings and who have had multiple documented severe asthma exacerbations despite daily high-dose inhaled corticosteroids, plus a long-acting inhaled beta2-agonist.

FEV1, forced expiratory volume in 1 second; ICS, inhaled corticosteroid; IgE, immunoglobulin E; LABA, long-acting beta2-agonist; OCS, oral corticosteroid; SAA, severe allergic asthma.

References:

  1. Papadopoulos NG et al. Allergy 2020;75(7):1555–1563.
  2. Viswanathan RK and Busse WW. Ann Allergy Asthma Immunol 2020;125(2):137–149.
  3. NICE Asthma: Diagnosis, Monitoring and Chronic Asthma Management 2017. Available at: www.nice.org.uk/guidance/ng80. (Accessed August 2021).
  4. Xolair Summary of Product Characteristics. August 2020
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UK | September 2021 | 151031
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