Intranasal Omalizumab Use and Systemic Total Immunoglobulin E Levels

HealthDay News — In patients with birch pollen allergy, intranasal administration of omalizumab does not result in relevant change of allergen-specific and total immunoglobulin E (IgE) levels, according to a pilot study published in Allergy.

Julia Eckl-Dorna, MD, PhD, from the Medical University of Vienna, and colleagues performed a double-blind, placebo-controlled trial to assess the effect of a challenge involving intranasal administration of major birch pollen allergen Bet v 1, omalizumab, or placebo on the levels of total and allergen-specific IgE in patients with birch pollen allergy. Measurements of total and allergen-specific IgE, immunoglobulin G, and basophil sensitivity were taken before and 8 weeks after the challenge. Controls included subjects treated subcutaneously with either omalizumab or placebo.

The researchers found that intranasal challenge with Bet v 1 induced increases of Bet v 1-specific IgE levels by a median of 59.2%, which was significantly more than in the other treatment groups. In patients challenged with omalizumab, there were no relevant changes in allergen-specific and total IgE levels. Significant rises in total IgE and the presence of IgE-omalizumab complexes were seen with subcutaneous administration of omalizumab.

“Intranasal administration of allergen induced rises of allergen-specific IgE levels whereas intranasal administration of omalizumab did not enhance systemic total or allergen-specific IgE levels,” conclude the authors.

One author disclosed financial ties to the pharmaceutical industry.

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Eckl-Dorna J, Froschl R, Lupinek C, et al. Intranasal administration of allergen increases specific IgE whereas intranasal Omalizumab does not increase serum IgE levels – a pilot study [published online October 30, 2017]. Allergy. doi: 10.1111/all.13343