Domestic application of biological asthma treatment improves quality of life and reduces doctor visits
The benefits of the possibility of home application of omalizumab, a monoclonal antibody indicated for patients with severe allergic asthma, are summarized by Dr. Jakub Novosad, Ph.D., from the Institute of Clinical Immunology and Allergology, Charles University Medical Faculty and University Hospital Hradec Králové.
Mechanism of action and indications of omalizumab
Omalizumab (Xolair) is a humanized monoclonal antibody that selectively binds to human immunoglobulin IgE and prevents its binding to immune cells, thereby limiting their activation and degranulation. It is administered subcutaneously every 4 (or 2) weeks in adults, adolescents, and children from 6 years with proven IgE-mediated asthma.
Omalizumab is recommended as an add-on therapy for patients with severe persistent allergic asthma with reduced lung function (forced expiratory volume in one second [FEV1] < 80%), frequent symptoms, severe exacerbations even with high-dose inhaled corticosteroids and long-acting inhaled β2-agonists.
In the Czech Republic, omalizumab has been used since 2008. The number of treated patients is increasing, but it is estimated to be used in only about 10% of those who might be eligible for it. Experiences are very positive; omalizumab is highly effective in almost 90% of treated patients, which is more than elsewhere in the world.
Home application
The introduction of home administration of omalizumab has significantly simplified the situation for patients and healthcare providers. Patients do not have to travel to the center every 4 (or 2) weeks, saving their time and money and significantly reducing the burden on healthcare providers. A check-up once every 3 months is sufficient. Currently, there is an evident trend to make other s.c. biological anti-asthmatics available for home administration, including mepolizumab, benralizumab, and dupilumab.
Three conditions are necessary for home administration of omalizumab:
- The patient must be stable on the treatment and tolerate it well.
- They must be interested in this treatment.
- They must be able to administer the medication correctly.
So far, experiences clearly show that almost all stabilized patients are interested in self-treatment and manage it without any problems. In case of any uncertainties, they can call the center specialized in this treatment. There is also the possibility of cooperation with a general practitioner nearby.
Conclusion
Home administration of omalizumab increases patient comfort and helps them return to normal life without being limited by symptoms, exacerbations, and side effects of systemic corticosteroid therapy and without unnecessary time spent in waiting rooms.
Reducing the number of necessary visits to specialized centers is also a great benefit in the current situation resulting from measures against the spread of the new coronavirus SARS-CoV-2.
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Sources:
1. Omalizumab and the current trend in biological asthma treatment. Medicine After Graduation 2020; 1. Available at: www.tribune.cz/clanek/45434-omalizumab-a-soucasny-trend-v-biologicke-lecbe-astmatu
2. SPC Xolair. Available at: www.ema.europa.eu/en/documents/product-information/xolair-epar-product-information_cs.pdf
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