II. Indications (all required)
-
Asthma (all criteria required)
- See Severe Asthma
- Refractory moderate to Severe Persistent Asthma not controlled on Inhaled Corticosteroids
- Positive Allergy Testing for perennial inhaled allergen (e.g. mold, pollen, animal dander)
- Patients must be age 6 years or older
-
Food Allergy
- Prophylaxis of serious Food Allergy reactions from accidental exposure (egg, milk, peanuts, tree nuts)
- Indicated in high risk patients (e.g. Anaphylaxis to food allergan) OR dual indications (e.g. Asthma and Food Allergy)
- FDA approved indication in 2024
- (2024) Presc Lett 31(5): 28
III. Mechanism
- Recombinant humanized Monoclonal Antibody (rhu-MAB)
- Blocks IgE binding to Mast Cells and Basophils
- Prevents release of Allergic Reaction mediators
IV. Dosing
- Approved for age >=6 years old
- Dose determined by serum IgE level and body weight
- Usually 75 to 375 mg SQ every 2 to 4 weeks
- Must be given in clinical setting with observation (risk of Anaphylaxis)
V. Adverse Effects
- Serious and life-threatening
- May predispose to malignancy
- Anaphylaxis
- Requires administration in clinical setting
- Reaction may occur >2 hours after injection
- Highest risk with first 3 doses
- Other reactions
- Injection site reaction
- Upper Respiratory Infections (including Sinusitis, Pharyngitis)
- Headache
- Alopecia
- Musculoskeletal (Arthralgias, myalgias, limb pain)
VI. Efficacy
- Reduces Asthma Exacerbations, hospitalizations and Inhaled Corticosteroid dosing in Allergic Asthma
VII. Safety
- Pregnancy Category B
- Unknown safety in Lactation
VIII. Resources
IX. References
- (2020) Drugs for Asthma, Med Lett Drug Ther 62: 193-200
- Finn (2003) J Allergy Clin Immunol 111:278-84 [PubMed]
- Raymond (2023) Am Fam Physician 107(4): 358-68 [PubMed]