Drug1st-line biologic line2 diseases

Omalizumab

Anti-IgE monoclonal antibody

Response rate
Significant NPS reduction
Onset
4–8 weeks
Route
SC every 2–4 weeks (dose by IgE/weight)
Line
1st-line biologic
IgM effect
Reduces polyp score
Evidence level
green
Trial phase
Phase 4

Used across diseases

DiseaseResponse rateLineEvidence
Chronic Rhinosinusitis with Nasal PolypsSignificant NPS reduction1st-line biologicgreen
Hypocomplementemic Urticarial Vasculitis SyndromeCase reports suggest efficacy for urticarial symptomsInvestigationalred

Evidence summary

Binds free IgE, preventing mast cell/basophil activation. POLYP 1 and POLYP 2 trials showed significant NPS improvement, reduced congestion, and improved SNOT-22. FDA-approved 2020 for CRSwNP. May be preferred in patients with high IgE and comorbid allergic asthma.

Approved indications

Conditions for which Omalizumab has regulatory approval (not specific to rare diseases covered here):

Moderate-to-Severe Allergic AsthmaChronic Idiopathic UrticariaChronic Rhinosinusitis with Nasal Polyps

Drug identifiers

DrugBankDB00043
ATC CodeR03DX05
Open TargetsCHEMBL1201576

Molecular targets

MoleculeRoleExpressionEvidence
IgEAllergic effector immunoglobulinElevated (local and systemic)established

Sources (2)

DetailsGevaert P et al. (2020) Efficacy and safety of omalizumab in nasal polyposis: POLYP 1 and POLYP 2 trialsDOI
DetailsFokkens WJ et al. (2020) European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020)DOI