Xolair (Omalizumab) is a genetically engineered antibody against IgE. IgE is itself an antibody our body makes to fight off various allergens and other disease states. Using Xolair has proven effective in allergic asthma and so it stands to reason that allergic sinusitis should also be amenable to treatment. Our understanding of asthma and sinusitis is very similar, they are both airway inflammatory states with a multiplicity of triggers.

There have been some concerns raised about the safety of Xolair with relation to undermining our immune surveillance. A trend towards an increase in some types of cancer has been noted in some of the studies. We have a few patients on this therapy and they have had good results. However, it is very expensive and requires a bit of leg work to get it covered.

There is a novel use of this drug for rush immunotherapy. This really seems to make sense. This might condense the build up phase of allergy shots to weeks rather than months.