By S.H. Arshad, K. Suresh Babu, Stephen Holgate
Little new has been brought into the armamentarium for bronchial asthma remedy within the final thirty years except advancements in b2-adrenoceptor agonists, corticosteroids and cysteinyl leukotriene antagonists. in spite of the fact that, the advent of a completely humanised monoclonal antibody to immunoglobulin E (IgE) (omalizumab), should still supply a brand new method of treating allergic problems, with results that stretch past a unmarried affected organ and tissue. the ideal position of this new agent in therapy guidance might want to be rigorously evaluated, yet its transparent efficacy and protection supply a robust assertion in regards to the significance of IgE around the complete spectrum of allergic ailment. This pocketbook presents an illustrative precis of the position of IgE within the pathogenesis of bronchial asthma and allied allergic problems, in addition to the results of anti-IgE treatment within the administration of those stipulations.
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Additional resources for Anti-IgE Therapy in Asthma and Allergy
Increased and early use of anti-inflammatory agents is now considered in all grades of asthma severity. Pharmacotherapy is tailored to the grade of severity of the disease. The NHLBI/WHO expert panel report classifies asthma into four grades of severity: mild intermittent asthma, mild persistent asthma, moderate persistent asthma and severe persistent asthma (Table 1). By adhering to a management programme, an asthmatic should be able to achieve and maintain control of symptoms, prevent exacerbations, and maintain pulmonary function as close to normal levels as possible.
No patients treated with omalizumab developed anti52 Table 3 Omalizumab in the treatment of ragweed-induced seasonal allergic rhinitis. Subjects receiving the two higher doses had significantly reduced symptom scores and medication requirement. 05. DNSS, daily nasal symptom score; DOSS, daily ocular symptom score. Data from Casale et al (1999). bodies directed against the drug. Further analysis of the data suggests that the efficacy of omalizumab, in terms of improvement in symptoms, is related to its ability to decrease serum free IgE levels.
The P-K characteristics in children and adolescents have been found to be similar to those in adults after normalization for the weights. Adverse effects Animal studies have not shown any evidence of toxicity with administration of up to 100 mg/kg in mice and 50 mg/kg in monkeys, the proposed clinical doses being 2–4 mg/kg. There were also no reports of anaphylaxis following systemic administration. Furthermore, no significant presence of antibody formation against omalizumab was documented in these studies.
Anti-IgE Therapy in Asthma and Allergy by S.H. Arshad, K. Suresh Babu, Stephen Holgate