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What Diseases Does Omalizumab Treat?

Omalizumab, marketed as XOLAIR®, is primarily used to treat two conditions: moderate to severe persistent allergic asthma and chronic idiopathic urticaria (CIU). For asthma, it is prescribed for patients aged 6 years and older who have a positive skin test or in vitro reactivity to a perennial aeroallergen and whose symptoms are not adequately controlled with inhaled corticosteroids. In the case of CIU, it is used for patients aged 12 years and older who remain symptomatic despite H1 antihistamine treatment.

• Moderate to Severe Persistent Allergic Asthma: For patients aged 6 years and older.
• Chronic Idiopathic Urticaria (CIU): For patients aged 12 years and older.
• Not indicated for: Acute bronchospasm or status asthmaticus, and other forms of urticaria or allergic conditions.

Omalizumab Indications and Dosage

Omalizumab is indicated for the treatment of moderate to severe persistent allergic asthma in patients aged 6 years and older, as well as chronic idiopathic urticaria in patients aged 12 years and older. The dosage is based on the patient’s body weight and baseline IgE levels for asthma, whereas CIU treatment follows a fixed dosing schedule.

• Asthma Dosage: 75 to 375 mg subcutaneously every 2 or 4 weeks, based on body weight and serum total IgE level.
• CIU Dosage: 150 or 300 mg subcutaneously every 4 weeks, regardless of body weight or IgE levels.
• Dosage adjustments: Necessary with significant changes in body weight during treatment.

Omalizumab Side Effects and Allergic Reactions

Omalizumab can cause a variety of side effects, ranging from mild to severe. Common side effects include injection site reactions, upper respiratory infections, and headaches. Serious side effects, though rare, include anaphylaxis, malignancies, and severe thrombocytopenia. Anaphylaxis is particularly concerning and can occur after the first dose or after prolonged treatment.

• Common Side Effects:
  • Injection site reactions (pain, redness, swelling)
  • Upper respiratory tract infections
  • Headache
  • Fatigue
  • Arthralgia (joint pain)
• Serious Side Effects:
  • Anaphylaxis
  • Malignancies
  • Severe thrombocytopenia

Omalizumab Administration Technique

Omalizumab is administered via subcutaneous injection. The injection may take several seconds due to the viscosity of the solution, and it should be performed in a clinical setting where patients can be observed for any adverse reactions, particularly anaphylaxis. Proper reconstitution and handling are essential to ensure the effectiveness and safety of the treatment.

• Reconstitution: The lyophilized powder must be reconstituted with sterile water for injection before administration.
• Injection Sites: Upper arm, thigh, or abdomen; sites should be rotated to minimize irritation.
• Post-Injection Monitoring: Patients should be observed for signs of anaphylaxis for an appropriate period after administration, especially after the initial doses.

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