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July 15, 2003 — The new anti-IgE drug Xolair is a major treatment breakthrough for people with a serious form of allergic asthma and could eventually revolutionize how all allergic disease is treated, according to the American College of Allergy, Asthma & Immunology (ACAAI).
Anti-IgE will initially be indicated only for patients with moderate-to-severe allergic asthma, in whom asthma attacks are triggered by an allergic reaction to things like pollen, mold, dust mites and pet dander. People with less severe asthma, asthma not triggered by allergies, or other types of allergic disease, such as hay fever and food allergies, will not yet be candidates for the new treatment.
"Allergists and their patients have been anxiously awaiting approval of anti-IgE because it truly is the biggest breakthrough in allergy treatment in 30 years," said William E. Berger, M.D., M.B.A., president of the ACAAI and a lead investigator on clinical trials of anti-IgE. "We know many of our patients will be asking if this treatment can help them."
Anti-IgE is administered through an injection one or two times each month. It is the first drug to stop an allergic reaction before it starts by blocking the antibody that causes the reaction. Other therapies treat the symptoms of allergies or block reactions to specific allergens.
Because of the interest in this long-anticipated treatment, the ACAAI is providing information about the drug and how it might fit into a patient's treatment plan.
Candidates for treatment with the new drug include patients who:
· Have moderate-to-severe asthma that is triggered by allergies.
· Have allergic asthma that has not responded well to other treatments such as allergen specific immunotherapy (also known as allergy shots), prescription antihistamines and inhaled corticosteroids.
It's estimated that among 17 million Americans who have asthma, half of adults and 80 percent of children have allergic asthma. An estimated 5,000 die of asthma every year.
"This treatment can help us prevent life-threatening allergic asthma attacks in many of our patients," said Dr. Berger. "It will allow patients to enjoy a far greater quality of life. For example, some people for the first time will be able to comfortably visit a friend with a pet or sleep with the window open in the spring, things that most of us take for granted. Many of these patients also will be able to significantly decrease their reliance on other allergy and asthma medications."
But Dr. Berger noted that many patients with mild to moderate asthma who are not candidates for anti-IgE could be doing more to control their disease. In fact, it is often people with these milder cases who end up in the emergency room because they don't recognize the need for aggressive control of their asthma. The ACAAI has the following treatment guidelines to help asthma patients determine if they are getting the most effective care.
If you have asthma, your doctor should:
· Test and monitor your asthma symptoms, including taking a detailed medical history, performing a physical examination, measuring lung function with special tests and ordering additional tests as needed.
· Identify and take steps to control asthma triggers, like animal dander, dust mites, pollen, exercise and cigarette smoke.
· Explain treatment options, including both long-term and quick-relief drugs for asthma, and anti-allergy therapies like allergy shots.
· Provide ongoing education and support.
· Develop a written plan to monitor how well the disease is being controlled.