KNOCKING OUT ALLERGIC ASTHMA
Sneezing, itching, watery eyes. Allergies aren't fun -- especially when they cause asthma. Some people have such severe allergic asthma, they can't even go outside and are on oxygen 24/7. Now, a new drug offers much-needed relief.
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For most women, cooking isn't exactly a privilege, but for Christine O'Neal, having allergic asthma prevented her from doing much of anything.
Christine O'Neal
Has allergic asthma
"I was wheelchair-bound for awhile -- didn't even have enough air to go shopping."
Drugs didn't work and being in the ICU 5 different times prompted a constant fear.
Christine O'Neal
"Dying, yeah."
But then Christine tried Xolair. Unlike other meds, it's injected and doesn't just control asthma's symptoms -- it actually shuts off the allergic reaction before it starts -- attacking what's called the IgE antibody.
David Lang, MD
Allergy and Immunology Specialist
The Cleveland Clinic
Cleveland, OH
"As a physician, it can be very frustrating to care for patients with difficult-to-control asthma, so when we have a medication available that can improve outcomes such as this, it's exciting."
Studies show Xolair greatly improves patients' symptoms after six months of use. Christine noticed big improvements after just three.
David Lang, MD
"It's not a cure, but it can result in a major improvement in symptoms, particularly in one's quality of life."
Christine went from being in and out of the hospital to enjoying the outdoors with her son.
Christine O'Neal
"Oh, it's great. It's night and day. I've got my life back. I'd be pretty scared to find out where I was without it."
Now, she won't ever have to.
Xolair is FDA approved. It's best for patients with moderate to severe asthma who have year-round allergens. Patients take it once every two to four weeks. Doctor Lang says side effects from the drug include possible skin reactions where it's injected.
BACKGROUND: Allergic asthma is triggered by year-round allergens in the air. The National Institutes of Health estimates 60 percent of people in the United States with asthma have allergic asthma. Most asthma medications are categorized as either relievers or controllers. The relievers are medications that take away symptoms once they occur, but those don't control asthma in the sense of affecting the underlying inflammation that drives asthma symptoms. Within the controller category, there are a number of medications that are effective and safe and are widely prescribed. One new FDA-approved medication called Xolair (omalizumab) is unique, however, in that it can affect the allergy antibody IgE. As an anti-IgE medication, it can shut off the allergic reaction before it starts
XOLAIR: Anti-IgE medications act differently than other asthma medications. When Anti-IgE is injected, it attacks the IgE, or allergy antibody, and can shut off the allergic reaction before it starts. David Lang, M.D., an allergy and immunology specialist out of the Cleveland Clinic, says: "For individuals who have allergic asthma, this holds great potential to control the condition, particularly those with moderate to severe asthma. Recent evidence indicates that it also can favorably affect the inflammation that drives asthma symptoms." There's no other anti-IgE antibody right now that's approved by the FDA.
Doctors don't know yet how long patients will need to take Xolair for and whether at some point they can suspend treatment. They also don't know whether administration of this medication has the potential to actually change the nature of asthma and prevent disease progression in those asthmatics who are predisposed to or experience disease progression to a more severe and chronic form of asthma. Dr. Lang says that is currently being investigated.
SUCCESS: Dr. Lang says, "In properly-selected patients with allergic asthma, anti-IgE therapy can improve asthma and allow these patients to achieve better control of their condition. It's not a cure, but it can result in a major improvement in symptoms, particularly in one's quality of life."
SIDE EFFECTS: In Xolair's pivotal trials, researchers noted that there was an increase in the rate of malignancy in individuals randomized to anti-IgE therapy compared to individuals randomized to a placebo. They found 0.5 percent of individuals who received the drug compared with 0.2 percent who got placebo treatment developed a malignancy. However, Dr. Lang says: "This is a numerical increase, but it wasn't statistically significant. What was observed was that about 60 percent of the malignancies occurred within six months of entering into these trials and receiving the drug or receiving placebo, and that's too short a time for someone to develop a malignancy, so that the interpretation here would be individuals had the malignancies that hadn't yet been diagnosed, and they entered the trial and they were diagnosed."
CANDIDACY: Potential candidates for Xolair are patients with moderate to severe asthma who aren't able to effectively manage their asthma, meaning they're waking up at night because of their asthma, restricting their activities, and missing school or work.
Dottie Vasas, RN
Cleveland Clinic
9500 Euclid Avenue
Cleveland, OH 44195
vasad@ccf.org
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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