II. Indications (all required)

  1. See Severe Asthma
  2. Refractory moderate to Severe Persistent Asthma
  3. Positive Allergy Testing for perennial inhaled allergen
  4. Patients must be age 6 years or older

III. Mechanism

  1. Recombinant humanized Monoclonal Antibody (rhu-MAB)
  2. Blocks IgE binding to Mast Cells and Basophils
    1. Prevents release of Allergic Reaction mediators

IV. Adverse Effects

  1. Serious and life-threatening
    1. May predispose to malignancy
    2. Anaphylaxis
      1. Requires administration in clinical setting
      2. Reaction may occur within 2 hours of injection
  2. Other reactions
    1. Injection site reaction
    2. Upper Respiratory Infections (including Sinusitis, Pharyngitis)
    3. Headache
    4. Alopecia
    5. Musculoskeletal (Arthralgias, myalgias, limb pain)

VI. Cost

  1. Dose dependent
  2. Varies from $500 to over $3000 for one month supply

VII. Dosing

  1. Dose determined by serum IgE level
  2. Usually 150 to 375 mg SQ every 2-4 weeks
  3. Must be given in clinical setting with observation

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