Most people with chronic rhinosinusitis with nasal polyps (CRSwNP) are able to control their symptoms by using medicines that are sprayed into the nose or taken by mouth. But some people with this condition are not able to manage their symptoms with these treatments. In recent years, new medicines have been approved that work in a different way to help with the symptoms of this condition. These medicines, which are injected into the body, work directly on the body’s immune system to help reduce symptoms.
One of these injected medicines that may help to treat symptoms in people with this condition is called Xolair.
How Does Xolair Work for Chronic Rhinosinusitis With Nasal Polyps?
Nasal polyps are small growths in the lining of the nose or in the sinuses, which are spaces near the nose. In some cases, these growths are caused by a condition called chronic rhinosinusitis. People with chronic rhinosinusitis have swelling (inflammation) in the nose and sinuses that lasts for more than 3 months. Over time, this swelling can cause polyps to form.
For many people, nasal polyps do not cause symptoms. But in some cases, the polyps can get big enough to block the normal function of the nose and sinuses. This can cause nasal congestion, which can include a stuffy or blocked nose, a runny nose, sneezing, and loss of taste and smell. If the sinuses can’t drain the way they normally do, mucus may build up. This can be painful and the sinuses may become infected.
The key to treating nasal polyps that are caused by chronic rhinosinusitis is to reduce the amount of swelling in the nose and sinuses. This may help to shrink the polyps and reduce symptoms.
The active ingredient in Xolair is a medicine called omalizumab, which works by blocking a substance in the body called immunoglobulin E (IgE). The body produces large amounts of IgE when it senses an allergen (a substance that causes allergies). Blocking IgE can decrease the body’s response to allergens and reduce the swelling and irritation that occurs in people with chronic rhinosinusitis and nasal polyps.
Can Anyone With This Condition Use Xolair?
Most people with CRSwNP will be able to control their symptoms by using a type of medicine called a corticosteroid. This medicine can be sprayed directly into the nose (intranasal). But some people will still have symptoms after using an intranasal corticosteroid for a few months. These people may take a corticosteroid by mouth for a short period of time to help manage their symptoms. Some people may also have surgery to remove their nasal polyps.
Xolair may be another option for people who still have a lot of symptoms even after using an intranasal corticosteroid.
The POLYP Studies
Two clinical trials called POLYP 1 and POLYP 2 were done to see if Xolair was safe and effective for the treatment of CRSwNP. A little more than half of the people in the studies were male (62%-67%), and the studies took place in North America and Europe. The average age of the people was about 50.
Everyone in these studies had symptoms even though they were using an intranasal corticosteroid each day. Most people (81%) had completely lost their sense of smell. About half of the people in these studies had asthma.
Xolair was compared with placebo in both of these studies. The people in the studies did not know whether they were receiving the medicine or the placebo. They were told to continue using an intranasal corticosteroid every day during the study.
These studies measured efficacy in two ways. These measures were taken at the beginning of the study and again throughout the study.
- The size and number of nasal polyps in each person’s nose
- People were asked to rate their nasal congestion symptoms on a scale
What Benefits Were Seen in These Studies?
Size of nasal polyps. After 3 months of treatment, people who used Xolair were more likely to have fewer and smaller nasal polyps than the people who used placebo. This difference was still present after 6 months of treatment.
Nasal congestion symptoms. After 3 months of treatment, people who used Xolair had fewer symptoms of nasal congestion than the people who used placebo. This difference was still present after 6 months of treatment.
How Do I Use it?
Xolair is a liquid that is injected under the skin every 2-4 weeks. Your health care provider will decide whether you should receive it every 2 weeks or every 4 weeks. This will depend on your weight and the amount of IgE in your blood. It can be injected into the thigh, stomach, or outer area of the upper arm.
The first few times that you use Xolair, your health care provider will give you the dose in a health care setting. This will allow them to monitor you for any type of reaction to the dose. After the first few doses, you may continue to receive the dose in a health care setting. If you meet certain criteria, your health care provider may also give you the option to administer the dose yourself, at home.
The drug comes in two forms. The most common form is a pre-filled device called an autoinjector. This device is ready to be injected under the skin so you do not need to learn how to use a syringe and needle. The other form is a prefilled syringe with a needle, which is most often used in very young children. The prefilled syringe contains latex, but the autoinjector does not. Let your health care provider know if you have an allergy to latex so that they can prescribe the right form of Xolair.
If you and your health care provider decide that you will start giving your own doses at home, they will teach you how to inject the drug before you use it the first time. It is important to inject the drug properly so that you get the right dose. Your prescription should also come with “Instructions for Use,” which explains how to prepare and give a dose.
How Quickly Will Xolair wWork for Chronic Rhinosinusitis With Nasal Polyps?
If Xolair is working, your nasal congestion symptoms may start to improve within the first month of treatment. Symptoms may also continue to improve within the first few months.
Do not stop using Xolair or any other medicines for this condition without talking to your health care provider first, even if your symptoms have gotten better. Your symptoms may get worse again if you stop or change any of your medicines.
Tell your health care provider if Xolair does not seem to be improving your symptoms after 3-4 months. Your health care provider may discuss other options for treating this condition.
How Can I Prevent or Manage Side Effects?
In rare cases, some people may have a serious allergic reaction (anaphylaxis) after their first dose of Xolair. Your first dose of Xolair will always be given in a health care setting, where you will be monitored for an allergic reaction. If anything happens, trained professionals will be there to manage any side effects.
These are not all of the possible side effects of Xolair. Talk with your health care provider if you are having symptoms that bother you. If you experience anything that you think may be caused by Xolair, you can also report side effects to the FDA at 800-FDA-1088.
Are There Any Interactions With Other Medicines?
There are no known interactions between Xolair and other medicines. But it is still important for your health care provider to be aware of all the prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken.
Are There Any Special Steps Required to Get Xolair?
Xolair is a “specialty” medicine. This means that you can only get it from a specialty pharmacy and that it may require prior authorization from your insurance company. Your first dose of Xolair will always be given by a health care provider in a health care setting.
Is There a Coupon Card Available?
There is a savings coupon available from the manufacturer that may allow you to pay $0 for your prescription. Whether you are eligible depends on whether you have prescription insurance and what type of insurance you have. You can find out more at www.xolaircopay.com.
