A new treatment is making a dramatic difference in the lives of some Valley asthma patients whose asthma is caused primarily by allergies.

The new medication, Xolair, is in a completely new class of asthma and allergy treatment – it stops the allergic reaction before it even starts. All previous medications have worked on alleviating different processes in a chain reaction which is set off in the respiratory system when an asthma patient is exposed to allergic substances. Xolair is the first to stop the reaction from happening in the first place.

In the Valley, the medication is helping some patients to feel better than they ever dreamed possible. However, Xolair is not for everyone – patients must undergo allergy and blood tests to be pre-certified for insurance coverage of the medication. Some insurers have been reluctant to cover or slow to pay for the treatment. And without insurance coverage, the treatment is prohibitively expensive for most people. In addition, the medication is currently approved by the FDA only for adults and adolescents, ages 12 and older.

Despite these obstacles, some Valley asthma and allergy patients have described Xolair as an almost miraculous treatment. For example, one 12-year-old Harlingen boy who had severe asthma and skin allergies has been receiving Xolair injections for a year. Now, the boy has no symptoms – and, with his physician’s approval, has been able to gradually stop taking his other asthma medications. (No asthma patient should reduce or stop other medications, even if they are doing well on Xolair, unless instructed to do so by their doctor.)

“The average improvement we have seen is moderate to remarkable, with at least one ‘miracle case,’ in those who have been on Xolair for four months or more,” said William McKenna, M.D., an Allergist-Immunologist who is on the Medical Staff of Valley Baptist Medical Center-Harlingen.

Dr. McKenna, who is the first physician in the Valley to use the Xolair treatments, said his patients receive one to two Xolair injections once or twice a month, depending on the severity of their asthma and allergies.

“For those who have moderate to severe asthma, and who have not received the relief they would like in their usual asthma medications such as inhaled corticosteroids, this is a major new category of medicine that has the potential of significantly changing the effect that asthma has on their lives,” Dr. McKenna added.

One of Dr. McKenna’s patients who has moderate to severe asthma, a 45-year-old Harlingen resident, said he felt like “a new man” after his first Xolair shot. “I have never breathed this well in my life, except maybe after six days of taking Prednisone,” the patient said. Prednisone is an oral steroid administered to patients suffering severe asthma attacks – and is used as a last resort because of significant side effects. Doctors hope Xolair will help keep such patients off oral steroids – and out of the hospital and emergency room.

However, Xolair isn’t an emergency treatment, and patients are advised to keep “rescue medications” such as albutorol inhalers close at hand, in case they do start having trouble breathing or develop other asthma symptoms.

“Xolair provides something that gets to the basic level of what is a major trigger of asthma – allergy,” Dr. McKenna said. “If a person is helped by Xolair it means that their their asthma is caused by allergies, and those patients potentially can also be helped by allergy shots.”

Dr. McKenna noted that while Xolair stops the allergic reaction from starting, it doesn’t immunize the person against their allergies. As soon as a patient stops Xolair, they will soon be back to the same level they were before. But if the patient combines the Xolair treatment with allergy shots to boost their immunity, they may be able to eventually reduce and discontinue the Xolair treatments, while maintaining the benefit.

“Our patients who are receiving both Xolair and allergy shots have done even better than those who are receiving Xolair alone,” Dr. McKenna said. “And some of our patients have benefited from a new ‘rush immunotherapy’ allergy injection treatment that dramatically shortens the time it takes to build up their immunity.”

Asthma is a breathing disease that affects an estimated 17 million Americans. Under current guidelines, only a small percentage of the overall number of asthma patients might be considered good candidates for the new treatment. For more information on asthma and allergies, please consult your physician.

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