Does Xolair work for eczema? Is a question that has been asked by many atopic dermatitis sufferers since the drug came out. Omalizumab targets IgE and many patients with eczema have extremely high levels of IgE. The only problem is that it approved for patients who have asthma whose IgE go up to 700 IU/ml, many eczema sufferers have IgE levels in the thousands range. Nevertheless, a study was done in Taiwan published in the Journal of Allergy and Clinical Immunology titled “Efficacy of omalizumab in patients with atopic dermatitis: A systematic review and meta-analysis” to see if it works.
A total of 15 studies were pooled together, over 100 patients with eczema were identified, most of the patients (60%) had severe atopic dermatitis. Only 25% of the population had serum IgE values less than 700 IU/ml and 43% of patients showed IgE concentrations above 5000 IU/ml. Also 67% of the patients with eczema were treated with 600 mg or more of Xolair per month.
43% of those with eczema achieved excellent clinical response
27% showed satisfying results
30% showed irrelevant clinical changes or even deterioration
The patients whose IgE concentration of lower than 700 IU/ml were significantly associated with an excellent clinical response.
More than likely, the patients who have a very high IgE level would benefit more if the Xolair dosage was increased, but there are no current studies supporting that. Some patients had IgE levels greater than 5000 IU/ml and if they only received 300mg injection of Xolair, that probably is not enough to suppress the IgE levels in the serum. The patients who had severe eczema with lower IgE levels, showed greater benefit with Xolair injections.
There is no recommended dosage for patients whose pretreatment serum total IgE concentrations or body weight outside the limits of the dosing table. The association of serum IgE concentrations of less than 700 IU/ml with more favorable clinical responses in this analysis might be explained by better IgE neutralization in patients with lower concentrations of IgE under fixed dosages.
In conclusion, there is no concrete evidence of the overall effectiveness of Xolair (omalizumab) for atopic dermatitis (eczema). Forty three percent of the patients with atopic dermatitis (eczema) could achieve remarkable clinical response after Xolair treatment. Potential therapeutic benefits might be seen in selected patients with lower serum concentrations of IgE. The optimal dosage of Xolair for patients with eczema with higher IgE levels should be further studied.
To learn more about IgE and other potential eczema options, see below. If you suffer from eczema, speak to an allergy specialist to see what options are best available for you.