Identify your moderate-to-severe patients with allergic asthma

XOLAIR may be right for some of your patients. To make the correct assessment, consider XOLAIR for patients aged 12 and older who have:¹

• Moderate-to-severe persistent asthma
• Positive skin test and in vitro reactivity to a perennial aeroallergen
• IgE-mediated asthma (with IgE levels of 30 IU/mL to 700 IU/mL)
• Body weight between 66 lb and 330 lb
• Asthma symptoms that are inadequately controlled with inhaled corticosteroids (ICS)

Important Limitations of Use

• XOLAIR is not indicated for treatment of other allergic conditions
• XOLAIR is not indicated for the relief of acute bronchospasm or status asthmaticus
• XOLAIR is not indicated for use in pediatric patients less than 12 years of age

The NHLBI Guidelines include XOLAIR for consideration for patients in steps 5 and 6*^†1

Stepwise approach for managing asthma in youths aged >12 years and adults

EIB=exercise-induced bronchospasm; ICS=inhaled corticosteroid; LABA=long-acting inhaled beta₂-agonist;
LTRA=leukotriene receptor antagonist; SABA=short-acting beta₂-agonist.

See chart notes

Notes:¹

• The stepwise approach is meant to assist, not replace, the clinical decision-making required to meet individual patient needs
• If alternative treatment is used and response is inadequate, discontinue it and use the preferred treatment before stepping up
• Zileuton is a less desirable alternative due to limited studies as adjunctive therapy and the need to monitor liver function. Theophylline requires monitoring of serum concentration levels
• In step 6, before oral systemic corticosteroids are introduced, a trial of high-dose ICS + LABA + either LTRA, theophylline, or zileuton may be considered, although this approach has not been studied in clinical trials
• Step 1, 2, and 3 preferred therapies are based on Evidence A; step 3 alternative therapy is based on Evidence A for LTRA, Evidence B for theophylline, and Evidence D for zileuton. Step 4 preferred therapy is based on Evidence B, and alternative therapy is based on Evidence B for LTRA and theophylline and Evidence D for zileuton. Step 5 preferred therapy is based on Evidence B. Step 6 preferred therapy is based on (EPR—2 1997) and Evidence B for Omalizumab^‡
• Immunotherapy for steps 2-4 is based on Evidence B for house-dust mites, animal danders, and pollens; evidence is weak or lacking for molds and cockroaches. Evidence is strongest for immunotherapy with single allergens. The role of allergy in asthma is greater in children than in adults
• Clinicians who administer immunotherapy or Omalizumab should be prepared and equipped to identify and treat anaphylaxis that may occur

^‡For the full NHLBI Guidelines and an explanation of Evidence A-D,
click here.