Inhaled Steroids | Long-Acting Bronchodilators | Combination Medications | Anti-Leukotrienes | Anti-IgE Therapy |Oral Corticosteroids | Theophyllines

Anti Immunoglobulin E (Anti-IgE) Therapy

Anti-IgE treatment might be recommended if you have allergic asthma and you keep experiencing persistent symptoms despite taking your controller medications.

If you have allergic asthma (about 60% of asthma is caused by allergy), your symptoms are triggered when you inhale certain allergens in the air. These allergens cause a chain reaction that leads to inflammation in the lungs.

While inhaled steroids work by treating and reducing the inflammation, anti-IgE therapy works by keeping inflammation from developing in the first place. It does so by blocking immunoglobulin E, a substance in the body that is one of the underlying causes of inflammation in allergic asthma.

Anti-IgE therapy is only available by prescription. Unlike other asthma medications, it is not administered by pill or by inhaler. It needs to be injected once every two or four weeks by a doctor or other trained healthcare professional.

The only anti-IgE therapy available in Canada is omalizumab (Xolair®).

The most common side effects of anti-IgE therapy are: skin irritation or reaction at the site of the injection, and respiratory tract infections (e.g., common cold).

Frequently Asked Questions on Anti-IgE therapy

Who is Anti-IgE therapy for?
Anti-IgE therapy with omalizumab is for adults and adolescents (12 years of age and above) with moderate-to-severe, persistent allergic asthma who continue to have asthma symptoms even though they are taking inhaled steroids.
How quickly does anti-IgE therapy work?
It does take time for the IgE blocking to start working. It is normal not to feel a difference right away. It is important to keep getting your injections until your doctor tells you otherwise. In scientific studies testing omalizumab, the benefits of IgE therapy were shown in most patients by three months.
Does omalizumab (Xolair®) have any serious side effects?
In scientific studies, cancer was seen in a small number of patients receiving omalizumab, as well as in those receiving placebo injections. The rate was higher in patients treated with omalizumab than placebo (0.5% vs. 0.2%). This difference has not been conclusively linked to the omalizumab. Some patients in the studies had a serious allergic reaction called anaphylaxis. This was rare, occurring in less than 0.1% of patients. Doctors have been advised to observe patients for a period after omalizumab injection to make sure that no anaphylaxis develops. If it does, it can be treated.
Will I still need to keep taking my inhalers?
Yes. Anti-IgE therapy is meant to complement, not replace, your existing medications. Although many patients taking IgE therapy have been able to have the dose of their inhaled steroid decreased over time, you will still need to keep taking your other asthma medications as directed by your doctor.
How often is omalizumab given?
Depending on your body’s IgE level and your body weight, omalizumab will be given once every two or four weeks.
Who will administer the injection?
Omalizumab needs to be injected by a trained healthcare professional. You may be able to have it done at your usual doctor’s office. In some cases, your doctor will refer you to another location to have the injection given. There are specialty clinics in many Canadian cities that have been especially set up to give injections of omalizumab.