Re:IgE scores after starting Xolair

May 8, 2007

Thanks, Addy.

The Genentech rep did tell my doc not to pay any attention to IgE scores after

implementing Xolair. However, I don't agree with him. Genentech's purpose was

to sell a drug that controlled asthma with few side effects - they had no

interest, as I've read in academic papers, as to the levels of IgE after

implementation of IgE, so that aspect has not even been explored.

This is causing a tiny rift between myself and the doctor's office. I've had

2 months of treatment (4 series of injections at 300 mgs every 2 weeks) and

absolutely no improvement. In fact, I'm becoming suspicious that Xolair could

possibly be contributing to my chronic colds and flu these last 8 weeks but that

remains to be seen. It's not that the benefit drops off before the shots; no,

indeed, there just plain is no help. I know the doc's office says it takes 6

months but if the dose was right I think things would go better. I think this

is a major flaw in Genentech's approach.

With that in mind I found a very interesting article in J Allergy Clin

Immunol. 2006 Apr;117(4):759-66. It was indexed for MedLine.

" the ImmunoCAP system was sufficiently robust to provide accurate and

reproducible total and allergen-specific IgE antibody results in a clinical

setting where therapeutic levels of omalizumab are present in serum. CLINICAL

IMPLICATIONS: Accurate monitoring of total and allergen-specific IgE, together

with free IgE levels, in serum from patients on omalizumab may help optimize

dosing and maximize the efficacy of Xolair therapy. "

Does this mean that patients on Xolair should be checked re IgE to see if

they're receiving optimum doses? This is very recent as you can see by the

date so if I'm interpreting this correctly, there is a change in IgE testing on

Xolair.

Incidentally, when I was tested 3 years ago my IgE was 409 - it was tested

last fall at 355. These were both PRE Xolair. However, the 409 makes me

eligible for the highest dose of Xolair while the 355 does not. It seems like

that should have been taken into consideration. Could it make a difference as

to whether one is taking antihistamines or steroids at the time of testing?

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May 9, 2007

Errrrr - I have to admit to being confused that you are so frustrated

after seeing no improvement after only two months of treatment. We've

had many posts to the effect that it can take as much as a year to

see significant improvement. In fact, I can think of only a handful

of members who've seen improvement in LESS than three months. The

average range for folks in this group seems to be between three and

six months. For most of us, our bodies continue to make new IgE all

the time (hence our status as severe persistent allergic asthmatics),

so it takes time to get enough Xolair into our bodies where it binds

to a sufficient amount of IgE that we have MORE IgE binding to Xolair

than binding to the mast cells and causing allergic symptoms.

Improvement in symptoms most likely has more to do with the rate at

which individuals make new IgE than anything else.

IgE scores can vary widely from test to test. I would suggest that if you are

still

not seeing improvement after 3-4 months, you talk to your doc about

making the argument to your insurance provider about increasing your

dosage based on the higher (but older) IgE score. I know a couple of

folks here have been able to do similarly with success.

Good luck,

Addy

Group co-owner, IgE scores well above 500 all the time, saw

significant improvement after 3 months; quit allergy shots after 5

months; not looking back. Standard disclaimer about these being my

own experiences applies.

--- In , SD Designer <instdesgn1@...>

wrote:

>

> Thanks, Addy.

>

> The Genentech rep did tell my doc not to pay any attention to IgE

scores after implementing Xolair. However, I don't agree with him.

Genentech's purpose was to sell a drug that controlled asthma with

few side effects - they had no interest, as I've read in academic

papers, as to the levels of IgE after implementation of IgE, so that

aspect has not even been explored.

>

> This is causing a tiny rift between myself and the doctor's

office. I've had 2 months of treatment (4 series of injections at

300 mgs every 2 weeks) and absolutely no improvement. In fact, I'm

becoming suspicious that Xolair could possibly be contributing to my

chronic colds and flu these last 8 weeks but that remains to be

seen. It's not that the benefit drops off before the shots; no,

indeed, there just plain is no help. I know the doc's office says it

takes 6 months but if the dose was right I think things would go

better. I think this is a major flaw in Genentech's approach.

>

> With that in mind I found a very interesting article in J Allergy

Clin Immunol. 2006 Apr;117(4):759-66. It was indexed for MedLine.

>

> " the ImmunoCAP system was sufficiently robust to provide

accurate and reproducible total and allergen-specific IgE antibody

results in a clinical setting where therapeutic levels of omalizumab

are present in serum. CLINICAL IMPLICATIONS: Accurate monitoring of

total and allergen-specific IgE, together with free IgE levels, in

serum from patients on omalizumab may help optimize dosing and

maximize the efficacy of Xolair therapy. "

>

> Does this mean that patients on Xolair should be checked re IgE

to see if they're receiving optimum doses? This is very recent as

you can see by the date so if I'm interpreting this correctly, there

is a change in IgE testing on Xolair.

>

> Incidentally, when I was tested 3 years ago my IgE was 409 - it

was tested last fall at 355. These were both PRE Xolair. However,

the 409 makes me eligible for the highest dose of Xolair while the

355 does not. It seems like that should have been taken into

consideration. Could it make a difference as to whether one is

taking antihistamines or steroids at the time of testing?

>

> ---------------------------------

> It's here! Your new message!

> Get new email alerts with the free Toolbar.

>

May 17, 2007

I am just now reading this old post. I was on prednisone when my ige was done.

i have been on xolair for 6 months now and am not better better. does anyone

have any ideas?

pyle456 <coachmac@...> wrote: Errrrr - I have to admit to

being confused that you are so frustrated