Monday, July 27, 2009

Xolair

Note: This post is mostly for my family, but I decided to put it on here as there are others out there dealing with severe persistent allergic asthma. Knowledge is power!

When I first heard about Xolair and Omalizumab, I thought they sounded like characters out of a bad sci-fi novel, not asthma therapy. My Doctor first mentioned them about four or five months ago in passing (and butchered the word omalizumab) as treatment possibilities. When it was clear by the first of June, that inhaled corticosteroids were maintaining me at a sub-par level but not helping me get better, my doctor mentioned Xolair again. I took some blood tests, submitted my allergy “scratch” test results from last year, and the results of those tests qualified me for Xolair.

Xolair is the brand name for Omalizumab treatment. Omalizumab treatment attacks the IgE levels in the blood. The body produces antibodies in response to substances it perceives as threats. One of these antibodies is IgE which releases a variety of chemicals including histamines and lukotrienes which asct as messengers in stimulating acute bronchospasms in the airways. IgE doesn’t just play a part in intital attacks, but also the cascade attacks. 4-8 hours after the initial attack and exposure to the allergen, asthmatics may have a second attack which is called the allergic cascade. IgE plays a similar role in that too.

Xolair targets and attacks the IgE, which lessens the number of attacks, and allows many on it to live more normal lives. Xolair isn’t a cure, and it isn’t without its risks. The drug is new (approved in 2006 by the FDA), but there seems to be an association between Xolair and lymphoma which makes sense because these IgE receptors also do double duty by attacking cells that can lead to lymphoma. Xolair may also lead to heart problems, but the results of that study won’t be released until next year.

Xolair is incredibly expensive. The treatment runs 10k to 30k a year, and because of that there’s certain criteria that has to be met in order to go on the shot. Xolair treatment is only considered when cortisteroids aren’t helping to make a patient better. Although we haven’t received health insurance approval yet, my blood work and allergy test results show that I qualify for the drug.

After talking to my allergist and the pulmonologist, doing research on the treatment, talking to my family and close friends about it, I came to the decision that this is what needs to be done next so I can go back to leading a more normal life. I’ll continue to be on the cortisteroids, but hopefully we’ll be able to start cutting back on those after being on xolair for a period of time. Xolair isn’t a cure, but being healthier? That sounds great.

12 comments:

erinannie said...

If you want some more second opinions, I can refer you to my uncle, the Asthma and Allergist Specialist. Rumor has it he's supposed to be one of the best a and a doctors in the country.
(I'm thinking you've probably met him somewhere along the line. But I'm not sure. He's in Roanoke, has the same last name as me.
I'm sure for a friend he'd be willing to do a phone consult with you.

Putz said...

MY BOY TAKES ONE SHOT EVERY TWO WEEKS AT $1500 PER SHOT, yes that is right $i500 per shot every two weeks

Sherpa said...

Erin-
Yeah, I spoke with your uncle. Thanks for the offer. I've got three doctors actually, my allergist, pulmonologist, and the general practioner. I've talked to all three about the Xolair, done some research, and this is the next step for asthmatics like me. I'm maxxed out on the meds available to me, I'm doing everything else I need to, and it's not fixing the problem like it would for most people so this is the next step. Thanks for the kind offer though.

aisy said...

Whoa, i hope your insurance covers you... that is seriously awful! Guess I should be more grateful that I only have mild exercise induced asthma. Nothing to what you deal with...

SJ said...

Does this change your opinion over universal healthcare?

Sherpa said...
This comment has been removed by the author.
Sherpa said...

Aisy-Yeah, the insurance should pay for it. Thanks, but exercise induced asthma is a pain too. ;)


SJ-? No, it hasn't actually.

Anonymous said...

SJ - Universal health care would not guarantee improved access for expensive procedures - I'm afraid rationing would be inevitable.

Joy - Thanks for the info. I have read at the Xolair website. Did you inform your docs re the family hx of lymphoma? I'm still hopeful that 3 weeks of dry mountain air will improve your lungs.
LV MOM

Sherpa said...

Mom-

I think I mentioned that my grandfather died of lymphoma. Is there anyone else that I'm missing?

I'm hoping it helps too.

Anonymous said...

I'll take Clinton over the guy we have now as President

Anonymous said...

My friend, a cronic asmatic started taking xolair and is now basically asthma free ...

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