After 6 years with Xolair; a 3-year withdrawal follow-up

• Published in: Allergy (Copenhagen) 2010, Vol.65 (1), p.56-60
• Main Authors: Nopp, A, Johansson, S.G.O, Adédoyin, J, Ankerst, J, Palmqvist, M, Öman, H
• Format: Article
• Language: English
• Subjects: Adult; Aged; Allergens - immunology; Allergies; Animals; Anti-Asthmatic Agents - therapeutic use; Antibodies, Anti-Idiotypic; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Asthma; Asthma - drug therapy; Asthma - immunology; Basophils - drug effects; Basophils - immunology; Biological and medical sciences; Cats; CD-sens; Clinical Medicine; Clinical Trials as Topic; Dermatology; Drug therapy; Follow-Up Studies; Forced Expiratory Volume - drug effects; Forced Expiratory Volume - immunology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Hypersensitivity - drug therapy; Hypersensitivity - immunology; IgE antibody; Immunoglobulin E - blood; Immunoglobulin E - immunology; Klinisk medicin; Lungmedicin och allergi; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Omalizumab; Respiratory Medicine and Allergy; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Surveys and Questionnaires
• ISSN: 0105-4538; 1398-9995; 1398-9995
• DOI: 10.1111/j.1398-9995.2009.02144.x

This study reports the clinical and immunological state of patients 3 years after a 6-year period of Xolair treatment for severe allergic asthma. The patient's cat allergen sensitivity, measured as CD-sens, IgE and IgE- and IgG4 antibodies, was analysed and compared with asthma severity evaluated from FEV₁ and a questionnaire. Three years after treatment with Xolair was stopped, 12/18 patients reported improved or unchanged asthma compared with ongoing Xolair treatment. Most of the patients were in a stable clinical condition, 16/18 had not increased nightly asthma attacks and 14/18 little or no increase in medication. The CD-sens to cat was still significantly lower (P < 0.02) than untreated patients with allergic asthma and lower than expected from their serum IgE antibody levels. Most of the patients in this study had, still 3 years after closing of 6 years Xolair treatment, a surprisingly mild and stable asthma. Interestingly, the observed, considerable, downregulation of basophil allergen sensitivity, CD-sens, most likely representing mast cell allergen sensitivity, contributed to the clinical results.