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Gon Y, Ito R, Maruoka S, et al. Serum free IgE guided dose reduction of omalizumab: a case report. Allergy Asthma Clin Immunol. 2017;13:39doi: 10.1186/s13223-017-0211-z.
Gon, Y., Ito, R., Maruoka, S., Mizumura, K., Kozu, Y., Hiranuma, H., Iida, Y., Shikano, S., & Hashimoto, S. (2017). Serum free IgE guided dose reduction of omalizumab: a case report. Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 1339. https://doi.org/10.1186/s13223-017-0211-z
Gon, Yasuhiro, et al. "Serum free IgE guided dose reduction of omalizumab: a case report." Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology vol. 13 (2017): 39. doi: https://doi.org/10.1186/s13223-017-0211-z
Gon Y, Ito R, Maruoka S, Mizumura K, Kozu Y, Hiranuma H, Iida Y, Shikano S, Hashimoto S. Serum free IgE guided dose reduction of omalizumab: a case report. Allergy Asthma Clin Immunol. 2017 Aug 31;13:39. doi: 10.1186/s13223-017-0211-z. eCollection 2017. PMID: 28861109; PMCID: PMC5577842.
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Allergy Asthma Clin Immunol. 2017 Aug 31;13:39. doi: 10.1186/s13223-017-0211-z. eCollection 2017.

Serum free IgE guided dose reduction of omalizumab: a case report.

Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

Yasuhiro Gon, Reiko Ito, Shuichiro Maruoka, Kenji Mizumura, Yutaka Kozu, Hisato Hiranuma, Yuko Iida, Sotaro Shikano, Shu Hashimoto

Affiliations

  1. Division of Respiratory Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-Kamicho, Itabashiku, Tokyo 173-8610 Japan.

PMID: 28861109 PMCID: PMC5577842 DOI: 10.1186/s13223-017-0211-z

Abstract

BACKGROUND: Omalizumab is a human IgG1 antibody against IgE used as a therapy for sever asthmatic patients with asthma. According to the guidelines of the Global Initiative for Asthma, omalizumab is an add-on drug at treatment step 5 that is used for severe asthma patients who are allergic to perennial allergens. The effects of omalizumab for severe asthma therapy have been validated in multiple clinical studies. However, the long-term effects of omalizumab on IgE production and possibility of resetting of administration dose of omalizumab remain unknown.

CASE PRESENTATION: The serum total and free IgE levels were measured over time in a 63-year-old female patient with allergic asthma who was administered 375 mg omalizumab biweekly for 36 months. Her symptoms did not worsen and clinical course remained favorable after reducing the dose to 375 mg per month. The serum free IgE levels temporarily increased following a dose reduction of omalizumab. The serum free IgE trough level temporarily increased at 4 weeks after capable to reduce the dosage; however, thereafter, the serum free IgE level decreased to desired levels (below 30 ng/mL).

CONCLUSIONS: The present case shows the possibility of reducing the dose following the long-term use of omalizumab. Considering the high medical cost of omalizumab, the dose reduction may be a viable option. It may be useful to measure the serum free IgE level to appropriately identify patients in whom the dose can be reduced, and to carefully monitor the clinical course.

Keywords: Bronchial asthma; IgE; Omalizumab

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