Xolair for idiopathic angioedema may be used as treatment for patients who are suffering from uncontrolled swelling. Currently Xolair is approved for chronic idiopathic urticaria. But the underlying disease mechanism of chronic hives is similar to idiopathic angioedema.
Angioedema is defined as recurrent episodes of swelling of the deep dermis affecting the skin, GI tract and respiratory tissue. This accounts for nearly 100,000 ER visits a year in the US during which no causative agent is found. Idiopathic angioedema refers to episodes of angioedema without hives for which no explanation can be found despite a thorough investigation. Antihistamines have been found to help decrease symptoms in some patients.
Xolair is a recombinant, humanized IgG1 monoclonal antibody that binds to free IgE, preventing its binding to the high-affinity IgE receptor and reduces the receptor density on mast cells, basophils and dendritic cells. It was approved in 2014 by the FDA for patients who failed using antithistamines for chronic hives. Many patients who do have chronic hives also have symptoms of angioedema.
Xolair has been proposed for Idiopathic Angioedema. A recent study published in the Annals of Allergy, Asthma and Immunology titled “Omalizumab for treatment of idiopathic angiodema” looked to see if this treatment was effective. The study showed greater improvements with Xolair in the Angioedema Activity Score, Visual Analogue Scale, Angioedema Quality of Life Questionnaire and number of angioedema episodes per month in patients who received omalizumab vs. placebo.
In this 24 week treatment period, this study provides evidence that Xolair improves Idiopathic Angioedema. Xolair may serve as a viable diagnostic and therapeutic option for patients with idiopathic angioedema.