Treatment of allergic rhinitis and other immunoglobulin E-mediated diseases with anti-immunoglobulin E antibody.

Allergic diseases of the airways, including asthma and allergic rhinitis, remain highly prevalent with associated symptoms placing considerable restrictions on the physical, emotional, and social functioning of the affected individual. It is now recognized that immunoglobulin E (IgE) plays a central role in mediating the allergic response that follows exposure to allergens after an initial process of sensitization. This sensitization process results in the overproduction of antigen-specific IgE. Omalizumab, a recombinant humanized monoclonal antibody, is the first therapeutic agent specifically targeting IgE. It has been investigated extensively in the treatment of patients with allergic diseases and is approved in the United States only for the treatment of patients with moderate-to-severe persistent asthma. Although not currently approved by the Food and Drug Administration for this specific indication, omalizumab also has been shown to be effective in patients with seasonal and perennial allergic rhinitis. As expected with a systemic anti-IgE agent, omalizumab also has been found to be helpful in the treatment of patients with concomitant asthma and allergic rhinitis. The efficacy of omalizumab in a range of allergic diseases reaffirms the importance of IgE in the pathogenesis of these conditions and shows the potential benefit to be obtained by inhibiting IgE, especially in patients with more severe and comorbid allergic diseases.