Los Angeles Allergist

Los Angeles Allergist

Alan Khadavi, MD, APC
  • Home
  • Meet Dr. Khadavi
  • Conditions We Treat
  • Your First Visit
  • Insurance Accepted
  • Allergy and Asthma Info
    • Asthma Info
    • Allergic Rhinitis
    • Allergic Triggers
  • Blog
  • Media
  • Contact Us

9001 Wilshire Blvd. Suite 204
Beverly Hills, CA 90211
Phone: 310-282-8822

16260 Ventura Blvd., Suite 140
Encino, CA 91436
Phone: 818-528-7776

October 25, 2016 by Alan Khadavi

Ligelizumab (QGE031) vs. Omalizumab (Xolair)

Ligelizumab (QGE031) is currently being developed by Novartis for the treatment of allergic diseases mainly asthma and chronic spontaneous urticaria.  Allergic diseases are dependent on the development of increased IgE levels.  Allergen-specific IgE plays a role in the inflammatory cascade of allergic responses.  Allergic individuals with elevated IgE levels have increased allergic mediators (e.g. histamine, leukotrienes) after exposure to allergens.

Omalizumab (Xolair) was the first anti-IgE therapy and humanized monoclonal antibody for the treatment of moderate to severe persistent allergic asthma.  Omalizumab bind to the IgE molecule and prevents it from binding IgE receptors.  This dampens the allergic response in susceptible individuals.  It is also now approved for chronic idiopathic (spontaneous) urticaria.

Ligelizumab (QGE031) is a fully humanized IgG1 monoclonal antibody directed against human IgE that binds with greater affinity than omalizumab (Xolair).  Ligelizumab (QGE031) is designed to obtain greater suppression of IgE bound to mast cells and basophils compared to Xolair, this might translate into superior interruption of the allergic cascade and greater clinical efficacy in asthmatic patients.

A recent study published in The Journal of Allergy and Clinical Immunology tested 3 dose levels (24, 72 and 240 mg administered every 2 weeks) of Ligelizumab (QGE031) in patients with asthma and compared their effect on allergic airway and skin responses with those of Xolair (omalizumab) and placebo.

Ligelizumab (QGE031) enhanced and prolonged the suppression of IgE receptors on basophils, led to a more pronounced inhibition of allergy skin test responses and decreased the response of asthma allergy challenges more effectively than Xolair (omalizumab).  Whether the enhanced pharmacodynamic response of Ligelizumab (QGE031) translates into clinical benefits in patients with severe asthma and chronic urticaria is unknown, but it needs to be evaluated in patient populations in the future.

Ligelizumab (QGE031) was well tolerated in adults, the most common adverse events were nasopharyngitis and worsening asthma.  All adverse events were mild to moderate in nature.  No cases of anaphylaxis or hives were reported.

Ligelizumab (QGE031) is an exciting new medication being studied for allergic diseases.  In studies it has shown grater inhibition than Xolair (omalizumab) in binding to IgE.  Besides asthma this could have a great impact for patients who have chronic idiopathic urticaria.  As we have described in older posts, patients who have chronic hives may sometimes go up 12 weeks between injections for Xolair (omalizumab).  If Ligelizumab (QGE031) binds to IgE with greater affinity (up to 3-fold greater), theoretically for patients with chronic urticaria they may be able to go a longer period of time between injections.

The patent for Xolair (omalizumab) is set to expire in the European Union, August 2017 and in the United States, January 2020.

Stay tuned for more info on Ligelizumab (QGE031) as it goes through clinical drug trials.

Response of hives after treatment with Xolair

Xolair Treatment Duration for Hives

Update: January 20, 2020

Ligelizumab (QGE031) in a phase 2b trial demonstrated rapid onset of action, dose-dependent efficacy and superiority to omalizumab. More than 50% of patients taking 240 mg of ligelizumab were complete responders, a response rate twice that seen in omalizumab. Average relapse time for omalizumab was 4 weeks compared to 10 weeks for ligelizumab. Phase 3 studies have been initiated and more than 2000 patients will be recruited.

Another anti-IgE drug, UB-221 is being evaluated in phase 1 trials. UB-221 has an 8 fold higher binding affinity to free IgE and down-regulates IgE synthesis by binding to IgE on CD23.

Update: December 23, 2022

Recently completed phase 3 trials in CSU showed that ligelizumab was superior to placebo, but not omalizumab. As a result, further development of ligelizumab for CSU has been halted. It is being studied now for food allergy. This is despite it having a 40 fold higher affinity for IgE and a slower offloading time.

Filed Under: Allergy Medicine, Asthma, Blog, Urticaria

alan-khadavi
Dr. Alan Khadavi
Allergy & Asthma Specialist

Latest Posts

January 22, 2023

Is Benadryl Safe to use, or is it Time to Move on?

is benadryl safe

January 12, 2023

Airsupra for Asthma, a new rescue medication

airsupra

December 26, 2022

Cantaloupe Allergy comes in many flavors

cantaloupe allergy

December 23, 2022

Remibrutinib, a BTK inhibitor for Chronic Hives

remibrutininb

November 21, 2022

Eczema and Hard Water, is there a link?

eczema and hard water

November 19, 2022

Nucala, Fasenra or Dupixent for Severe Eosinophilic Asthma?

nucala fasenra dupixent

November 18, 2022

Xolair for idiopathic angioedema

xolair for idiopathic angioedema

September 29, 2022

When will my child outgrow egg allergy?

outgrow egg allergy

September 13, 2022

Can you be allergic to water? (Aquagenic Urticaria)

allergic to water

September 8, 2022

Oclacitinib for Atopic Dermatitis (Eczema) in Dogs

oclacitinib

Read More Posts...

Follow Us…

© 2023 Allergy Los Angeles. All Rights Reserved · Log in · Return to top of page