Many patients with asthma are well controlled on what we refer to as “conventional therapy”. This usually means the use of inhaled medications, such as inhaled corticosteroids (the mainstay of therapy) and long acting bronchodilators. Patients are usually offered a “rescue inhaler” for flare ups.
During the initial evaluation of asthma patients, it is helpful to assess other aspects of their disease. Specifically, we often want to know something about their immune system and responses to allergens. Allergy testing can be used, but most helpful initially is a check on the patient’s IgE level.
IgE is a protein in the blood called an immunoglobulin. IgE is one of the components of the inflammatory cascade that is occurring in the airways and blood of patients with asthma. In some cases an elevated IgE level makes it difficult to control a patient’s asthma with conventional therapy. Patients with this problem will have frequent exacerbations and need frequent courses of oral corticosteroids, such as prednisone, to keep their symptoms in check.
A drug called Xolair is used to block the IgE mechanism and provide greater control for asthma patients. Like any drug, safety is a broad concern. Until recently, only short term safety data was available for this drug. A recent study has found safety and tolerability to Xolair for 9 years. Those of you reading this article and taking this specialized drug therapy can breathe a sigh of relief in knowing that your treatment is not just effective, but safe as well.