Omalizumab (Xolair)
Anti-IgE monoclonal antibody
- Response rate
- Variable; effective for refractory anaphylaxis
- Onset
- Months
- Route
- SC monthly injection
- Line
- 3rd
- IgM effect
- N/A
Evidence summary
Anti-IgE biologic used off-label for SM patients with refractory anaphylaxis despite antihistamines. Reduces IgE-mediated degranulation events. Observational data show significant reduction in anaphylaxis episodes. Small RCTs have not conclusively demonstrated efficacy for all SM symptoms.