Xolair Is Effective in Allergics with a Low Serum IgE Level

Abstract

Background: Two atopic patients suffering from severe allergy difficult to handle by conventional medication were given Xolair despite an IgE level <30 kU/l. Methods: Increasing dosages were given and monitored by clinical evaluation and CD-sens to clinically relevant allergens. The patients’ IgE antibody fractions were 11–14%. Results: Xolair dosages extrapolated from a recommended dose for IgE of 30–75 kU/l were adapted to the patients’ IgE body pool but had very little effect. The double dose resulted in some clinical improvement and a decrease in CD-sens. However, not until the dose was doubled again did the patients become symptom free, although 1 patient needed some additional drugs but no oral steroids. CD-sens turned negative to 5 of the 7 tested allergens. Conclusions: Xolair is most useful also in atopics with an IgE level <30 kU/l. The dose must be adjusted to the size of the IgE antibody fraction adding all non-cross-reacting, clinically relevant specificities.

Pre‐treatment by omalizumab allows allergen immunotherapy in children and young adults with severe allergic asthma

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Effectiveness of Omalizumab in a Patient with Severe Asthma, Low Serum IgE Level, and Lack of Sensitized Allergens Induced by Oral Steroid Therapy: The Usefulness of Impulse Oscillation for Assessment of Omalizumab Therapy

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Individually dosed omalizumab: an effective treatment for severe peanut allergy

“…However, previous studies show good correlations between CD-sens to peanut and clinical allergy to peanut, that is objective symptoms in DBPCFC [22,24]. The correlation between CD-sens and clinical allergen sensitivity has been used, in previous studies, to identify omalizumab responders as well as to evaluate treatment efficacy after omalizumab dose adjustments [20,21,32]. Measurements of basophil allergen threshold sensitivity, for example CD-sens, have been shown to correlate significantly with the outcome of bronchial, nasal allergen titration challenge and oral challenges [22,23,[29][30][31].…”

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