Omalizumab

Omalizumab
Omalizumab syringe
Monoclonal antibody
TypeWhole antibody
SourceHumanized (from mouse)
TargetIgE Fc region
Names
Pronunciationoh-ma-liz'-oom-ab
Trade namesXolair
Clinical data
Main usesAsthma, nasal polyps, urticaria[1][2]
Side effectsHeadache, pain at the site of injection, itching, abdominal pain[1]
WHO AWaReUnlinkedWikibase error: ⧼unlinkedwikibase-error-statements-entity-not-set⧽
Pregnancy
category
  • AU: B1
    Routes of
    use    		Subcutaneous
    Typical dose150 to 750 mg[2]
    External links
    AHFS/Drugs.comMonograph
    MedlinePlusa603031
    Legal
    License data
    Legal status
    Pharmacokinetics
    Elimination half-life26 days
    Chemical and physical data
    FormulaC6450H9916N1714O2023S38
    Molar mass145058.53 g·mol−1

    Omalizumab, sold under the brand name Xolair, is a medication used to treat asthma, nasal polyps, and urticaria.[1][2] It is used when the cause is allergic and other treatments are not sufficient.[1] It is given by injection.[1]

    Common side effects include headache, pain at the site of injection, itching, and abdominal pain.[1] Other side effects may include anaphylaxis, cancer, and heart disease.[2] Following use in a small number of pregnant women there is no evidence of harm to the baby.[8] It is a monoclonal antibody which binds to and inactivates immunoglobulin E (IgE).[1]

    Omalizumab was approved for medical use in the United States in 2003 and Europe in 2005.[2][1] In the United Kingdom 150 mg cost the NHS about £260 as of 2021.[9] This amount in the United States costs about 1,200 USD.[10]

    Medical uses

    In the United States, omalizumab is indicated to treat moderate to severe persistent asthma, nasal polyps, and chronic idiopathic urticaria.[7]

    In the European Union, omalizumab is indicated to treat allergic asthma, chronic (long-term) spontaneous urticaria (itchy rash), severe chronic rhinosinusitis with nasal polyps.[1]

    In Australia, omalizumab is indicated to treat allergic asthma and chronic spontaneous urticaria.[3]

    Allergic asthma

    Omalizumab is used to treat people with severe, persistent allergic asthma, uncontrollable with by mouth or injectable corticosteroids.[11] Those people have already failed step I to step IV treatments and are in step V of treatment. Such a treatment is consistent with guidelines issued by Global Initiative of Asthma (GINA).[12]

    Urticaria

    Omalizumab is indicated for chronic spontaneous urticaria in adults and adolescents (>12 years old) poorly responsive to H1-antihistamine therapy.[13][14] When administered subcutaneously once every four weeks, omalizumab has been shown to significantly decrease itch severity and hive count.[13][14][15]

    Dosage

    It is given once every 2 to 4 weeks.[2] Each dose is 150 to 750 mg.[2]

    Side effects

    The main side effect is anaphylaxis (a life-threatening systemic allergic reaction), with a rate of occurrence of 1 to 2 patients per 1,000.[11][16]

    Another potential side effect is eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).[9]

    Limited studies are available to confirm whether omalizumab increases the risk of developing cardiovascular (CV) or cerebrovascular disease (CBV). Cohort and randomised controlled studies have shown that the risk of developing CV/CBV disease is around 20-32% higher in patients taking omalizumab compared to those not taking omalizumab[46,47]. Additional multi-national, longitudinal studies with increased subject numbers are required to provide further clarification into the relationship and clinical significance between omalizumab and CV/CBV disease[46,47]. Due to the severity of CV/CBVs side effects, clinicians and health care providers should continue to remain vigilant and monitor side effects when treating patients with omalizumab.

    IgE may play an important role in the immune system's recognition of cancer cells.[17] Therefore, indiscriminate blocking of IgE-receptor interaction with omalizumab may have unforeseen risks. The data pooled in 2003 from the earlier phase I to phase III clinical trials showed a numeric imbalance in malignancies arising in omalizumab recipients (0.5%) compared with control subjects (0.2%).[11] A 2012 study found that a causal link with cancer was unlikely.[18]

    Mechanism of action

    The rationale for designing the anti-IgE therapeutic antibodies and the pharmacological mechanisms of anti-IgE therapy have been summarized in review articles by the inventor of the anti-IgE therapy, Tse Wen Chang, and his colleagues.[19][20][21]

    Perhaps the most dramatic effect, which was not foreseen at the time when the anti-IgE therapy was designed and which was discovered during clinical trials, is that as the free IgE in patients is depleted by omalizumab, the FcεRI receptors on basophils, mast cells, and dendritic cells are gradually down-regulated with somewhat different kinetics, rendering those cells much less sensitive to stimulation by allergens.[22][23][24] Thus, therapeutic anti-IgE antibodies such as omalizumab represent a new class of potent mast cell stabilizers.[21] This is now thought to be the fundamental mechanism for omalizumab's effects on allergic and non-allergic diseases involving mast cell degranulation. Many investigators have identified or elucidated a host of pharmacological effects, which help bring down the inflammatory status in omalizumab-treated patients.[25][26][27]

    Allergic diseases

    In conjunction with achieving the practical goal to investigate the applicability of the anti-IgE therapy as a potential treatment for allergic diseases, the many corporate-sponsored clinical trials of TNX-901 and omalizumab on asthma, allergic rhinitis, peanut allergy, chronic idiopathic urticaria, atopic dermatitis, and other allergic diseases, have helped define the role of IgE in the pathogenesis of these prevalent allergic diseases. For example, the clinical trial results of omalizumab on asthma have unambiguously settled the long debate whether IgE plays a central role in the pathogenesis of asthma.[26] Numerous investigator-initiated case studies or small-scale pilot studies of omalizumab have been performed on various allergic diseases and several non-allergic diseases, especially inflammatory skin diseases. These diseases include atopic dermatitis, various subtypes of physical urticaria (solar, cold-induced, local heat-induced, or delayed pressure-induced), and a spectrum of relatively less prevalent allergic or non-allergic diseases or conditions, such as allergic bronchopulmonary aspergillosis,[28] cutaneous or systemic mastocytosis, bee venom sensitivity (anaphylaxis),[29] idiopathic anaphylaxis, eosinophil-associated gastrointestinal disorder, bullous pemphigoid,[30] interstitial cystitis,[31] nasal polyps, and idiopathic angiodema,.[32]

    Non-allergic diseases

    Several groups have reported clinical trial results that omalizumab may be effective in patients with non-allergic asthma.[33] This seems to be contrary to the general understanding of the pharmacological mechanisms of the anti-IgE therapy discussed above.[34] Furthermore, among the diseases in which omalizumab has been studied for efficacy and safety, some are not allergic diseases, because hypersensitivity reactions toward external antigens is not involved. For example, a portion of the cases of chronic idiopathic urticaria[35][36] and all cases of bullous pemphigoid[30] are clearly autoimmune diseases. For the remaining cases of chronic idiopathic urticaria and those of the different subtypes of physical urticaria, the internal abnormalities leading to the disease manifestation have not been identified. Notwithstanding these developments, it is apparent that many of those diseases involve inflammatory reactions in the skin and the activation of mast cells. An increasing series of papers have shown that IgE potentiates the activities of mast cells[37] and omalizumab can function as a mast cell-stabilizing agent,[21] rendering these inflammatory cells to be less active.

    Chemistry

    Omalizumab is a glycosylated IgG1 monoclonal antibody produced by cells of an adapted Chinese hamster ovary (CHO) cell line.[19] The antibody molecules are secreted by the host cells in a cell culture process employing large-scale bioreactors. At the end of culturing, the IgG contained in the medium is purified by an affinity-column using Protein A as the adsorbent, followed by chromatography steps, and finally concentrated by UF/DF (paired ultra filtration/depth filtration). Omalizumab is manufactured at the Novartis' Huningue manufacturing site (France)[38] through a partnership agreement with Genentech.

    Omalizumab was for several years provided only in a dry powder formulation, which requires the reconstitution with a prepacked solvent with the help of a shaker at the treating clinician's office before injection. A prefilled syringe liquid formulation has become available in many countries.[39]

    History

    The product concept of anti-IgE antibodies against autologous IgE epitopes was discovered by perinatal monoclonal IgE immunization in rodents prior to the emergence of endogenous self IgE [40][41] by Swey-Shen Chen at the Scripps Research Institute (TSRI) and in Case Western Reserve University (CWRU),[42] and later confirmed by Dr. Alfred Nisonoff at Brandeis University using monoclonal IgE in incomplete Freund's adjuvant in perinates.[43] Immunized or vaccinated rodents will develop low or undetectable levels of circulating IgE in a long-term IgE tolerance. Consequently, the passive monoclonal antibodies against human IgE can be tested for neutralizing pathological levels circulating IgE in allergic patients. Swey-Shen Chen was later an advisory consultant of Tanox, Inc. Tanox, a biopharmaceutical company based in Houston, Texas, started the anti-IgE program, created antibody drug candidates, and filed its first patent application on the anti-IgE therapeutic approach in 1987.[44] In the next year, the company converted one candidate antibody to a chimeric antibody (which was later named CGP51901 and further developed into a humanized antibody, TNX-901 or talizumab). The anti-IgE therapeutic concept was not well received in the early period of the program. In order to seek funding for the anti-IgE program, the two scientist founders of Tanox, Nancy T. Chang and Tse Wen Chang, visited about 25 pharmaceutical and larger biotech companies in the U.S., Canada, Europe, Japan, and other countries to discuss collaboration throughout 1989. Representatives of Ciba-Geigy (which merged with Sandoz to form Novartis in 1996) thought the anti-IgE program scientifically interesting and executives from Tanox and Ciba-Geigy signed a collaborative agreement in 1990 to develop the anti-IgE program.[44][45]

    In 1991, after several rounds of pre-IND ("investigational new drug") meetings with officials/scientists of the FDA, the FDA finally gave a nod for CGP51901 to be tested in human subjects. This approval of IND for an anti-IgE antibody for the first time was regarded a brave demonstration of professionalism for both the FDA officials and the Tanox/Ciba-Geigy team. The scientists participating in the pre-IND discussion comprehended that an ordinary anti-IgE antibody (i.e., one without the set of binding specificity of CGP51901) would invariably activate mast cells and basophils and cause anaphylactic shocks and probably deaths among injected persons. Notwithstanding this concern, they came to the same view that based on the presented scientific data, CGP51901 should have an absolutely required clean distinction from an ordinary anti-IgE antibody in this regard.[46][47] In 1991–1993, researchers from Ciba-Geigy and Tanox and a leading clinical research group (headed by Stephen Holgate) in the asthma/allergy field ran a successful Phase I human clinical trial of CGP51901 in Southampton, England and showed that the tested antibody is safe.[48] In 1994–1995, the Tanox/Ciba-Geigy team conducted a Phase II trial of CGP51901 in patients with severe allergic rhinitis in Texas and showed that CGP51901 is safe and efficacious in relieving allergic symptoms.[49]

    While the Tanox/Ciba-Geigy anti-IgE program was gaining momentum, Genentech announced in 1993 that it also had an anti-IgE program for developing antibody therapeutics for asthma and other allergic diseases. Scientists in Genentech had made a mouse anti-IgE monoclonal antibody with the binding specificity similar to that of CGP51901 and subsequently humanized the antibody (the antibody was later named "omalizumab").[50] This caused great concerns in Tanox, because it had disclosed its anti-IgE technology and sent its anti-IgE antibody candidate, which was to become CGP51901 and TNX-901, to Genentech in 1989 for the latter to evaluate for the purpose of considering establishing a corporate partnership.[51] Having failed to receive reconciliation from Genentech, Tanox filed a lawsuit against Genentech for trade secret violation.[51] Coincidentally, Tanox started to receive major patents for its anti-IgE invention from the European Union and from the U.S. in 1995.[52] After a 3-year legal entanglement, Genentech and Tanox settled their lawsuits out-of-court and Tanox, Novartis, and Genentech formed a tripartite partnership to jointly develop the anti-IgE program in 1996.[53] Omalizumab became the drug of choice for further development, because it had a better developed manufacturing process than TNX-901.[53] A large number of corporate-sponsored clinical trials and physician-initiated case series studies on omalizumab have been planned and performed since 1996 and a large number of research reports, especially those of clinical trial results, have been published since around 2000, as described and referenced in other sections of this article. In 2007, Genetech bought Tanox at $20/share for approximately $900 Million.[54][55]

    Society and culture

    Due to the high cost of an omalizumab, and the concern over long-term safety, treatment is not yet very common, especially in developing countries. Another barrier to wide use is its injectable dosage form. In August 2010, the National Institute for Clinical Excellence (NICE) in the United Kingdom ruled that omalizumab should not be prescribed on the National Health Service (NHS) to children under 12.[56] NICE concluded that the high costs of the compound, over £250 per vial, did not represent a sufficiently high increase in quality of life. However, on March 7, 2013, NICE issued “final draft guidance” about the allowance of omalizumab. It recommended the medication as an option for treating severe, persistent allergic asthma in adults, adolescents and children following additional analyses and submission of a patient access scheme (PAS) by Novartis, the manufacturer.[57]

    In August 2013, a researcher at Leiden University Medical Center responsible for the TIGER trial was fired for unrelated research fraud. The TIGER trial was halted as a result.[58]

    In the United States it costs about US$540 to $4,600 per month as of 2020.[59]

    References

    1. 1 2 3 4 5 6 7 8 9 10 "Xolair EPAR". European Medicines Agency (EMA). Archived from the original on 13 June 2021. Retrieved 12 June 2021.
    2. 1 2 3 4 5 6 7 "Omalizumab Monograph for Professionals". Drugs.com. Archived from the original on 11 January 2020. Retrieved 8 November 2021.
    3. 1 2 "Archive copy" (PDF). Archived (PDF) from the original on 2021-06-13. Retrieved 2021-07-15.{{cite web}}: CS1 maint: archived copy as title (link)
    4. ↑ "Archive copy" (PDF). Archived (PDF) from the original on 2021-08-28. Retrieved 2021-07-15.{{cite web}}: CS1 maint: archived copy as title (link)
    5. ↑ "Novartis announces that Xolair is approved in Canada as a licensed therapy for chronic idiopathic urticaria (CIU) patients unresponsive to antihistamines". Novartis (Press release). 28 August 2014. Archived from the original on 13 June 2021. Retrieved 12 June 2021 – via PR Newswire.
    6. ↑ "Xolair 75 mg solution for injection in pre-filled syringe - Summary of Product Characteristics (SmPC)". (emc). 18 August 2020. Archived from the original on 13 June 2021. Retrieved 12 June 2021.
    7. 1 2 "Xolair- omalizumab injection, solution Xolair PFS- omalizumab injection, solution". DailyMed. 11 May 2020. Archived from the original on 28 November 2020. Retrieved 6 December 2020.
    8. ↑ "Omalizumab (Xolair) Use During Pregnancy". Drugs.com. Archived from the original on 4 December 2020. Retrieved 8 November 2021.
    9. 1 2 BNF 81: March-September 2021. BMJ Group and the Pharmaceutical Press. 2021. p. 285. ISBN 978-0857114105.
    10. ↑ "Xolair Prices, Coupons & Patient Assistance Programs". Drugs.com. Archived from the original on 19 January 2021. Retrieved 8 November 2021.
    11. 1 2 3 Davydov L (January 2005). "Omalizumab (Xolair) for treatment of asthma". Am Fam Physician. 71 (2): 341–2. PMID 15686303.
    12. ↑ "Pocket guide for asthma management and prevention. Global Initiatives for Asthma". 2013. Archived from the original on 2013-05-21. Retrieved 2013-07-07.
    13. 1 2 Urgert, M.C.; Elzen, M.T.; Knulst, A.C.; Fedorowicz, Z.; Zuuren, E.J. (22 July 2015). "Omalizumab in patients with chronic spontaneous urticaria: a systematic review and assessment". British Journal of Dermatology. 173 (2): 404–415. doi:10.1111/bjd.13845. PMID 25891046. S2CID 22874727.
    14. 1 2 Bernstein, Jonathan A.; Kavati, Abhishek; Tharp, Michael D.; Ortiz, Benjamin; MacDonald, Karen; Denhaerynck, Kris; Abraham, Ivo (16 February 2018). "Effectiveness of omalizumab in adolescent and adult patients with chronic idiopathic/spontaneous urticaria: a systematic review of 'real-world' evidence". Expert Opinion on Biological Therapy. 18 (4): 425–448. doi:10.1080/14712598.2018.1438406. PMID 29431518.
    15. ↑ Zhao, Zuo-Tao; Ji, Chun-Mei; Yu, Wen-Jun; Meng, Ling; Hawro, Tomasz; Wei, Ji-Fu; Maurer, Marcus (June 2016). "Omalizumab for the treatment of chronic spontaneous urticaria: A meta-analysis of randomized clinical trials". Journal of Allergy and Clinical Immunology. 137 (6): 1742–1750.e4. doi:10.1016/j.jaci.2015.12.1342. PMID 27040372.
    16. ↑ Fanta CH (March 2009). "Asthma". N. Engl. J. Med. 360 (10): 1002–14. doi:10.1056/NEJMra0804579. PMID 19264689.
    17. ↑ Karagiannis SN, Wang Q, East N, Burke F, Riffard S, Bracher MG, Thompson RG, Durham SR, Schwartz LB, Balkwill FR, Gould HJ (April 2003). "Activity of human monocytes in IgE antibody-dependent surveillance and killing of ovarian tumor cells". Eur. J. Immunol. 33 (4): 1030–40. doi:10.1002/eji.200323185. PMID 12672069. S2CID 29495137.
    18. ↑ Busse W, Buhl R, Fernandez Vidaurre C, Blogg M, Zhu J, Eisner MD, Canvin J (April 2012). "Omalizumab and the risk of malignancy: results from a pooled analysis". The Journal of Allergy and Clinical Immunology. 129 (4): 983–9.e6. doi:10.1016/j.jaci.2012.01.033. PMID 22365654.
    19. 1 2 Chang, TW; Wu, PC; Hsu, CL; Hung, AF (2007). "Anti-IgE antibodies for the treatment of IgE-mediated allergic diseases". Advances in immunology. 93: 63–119. doi:10.1016/S0065-2776(06)93002-8. PMID 17383539.
    20. ↑ Chang TW (February 2000). "The pharmacological basis of anti-IgE therapy". Nat. Biotechnol. 18 (2): 157–62. doi:10.1038/72601. PMID 10657120. S2CID 22688959.
    21. 1 2 3 Chang TW, Shiung YY (June 2006). "Anti-IgE as a mast cell-stabilizing therapeutic agent". The Journal of Allergy and Clinical Immunology. 117 (6): 1203–12. doi:10.1016/j.jaci.2006.04.005. PMID 16750976.
    22. ↑ MacGlashan DW, Bochner BS, Adelman DC, Jardieu PM, Togias A, McKenzie-White J, Sterbinsky SA, Hamilton RG, Lichtenstein LM (February 1997). "Down-regulation of Fc(epsilon)RI expression on human basophils during in vivo treatment of atopic patients with anti-IgE antibody". Journal of Immunology. 158 (3): 1438–45. PMID 9013989.
    23. ↑ Prussin C, Griffith DT, Boesel KM, Lin H, Foster B, Casale TB (December 2003). "Omalizumab treatment downregulates dendritic cell FcepsilonRI expression". The Journal of Allergy and Clinical Immunology. 112 (6): 1147–54. doi:10.1016/j.jaci.2003.10.003. PMID 14657874. Archived (PDF) from the original on 2021-08-28. Retrieved 2021-07-15.
    24. ↑ Scheinfeld N (2005). "Omalizumab: a recombinant humanized monoclonal IgE-blocking antibody". Dermatol. Online J. 11 (1): 2. doi:10.5070/D30MC9C9TW. PMID 15748543.
    25. ↑ Holgate ST, Djukanović R, Casale T, Bousquet J (April 2005). "Anti-immunoglobulin E treatment with omalizumab in allergic diseases: an update on anti-inflammatory activity and clinical efficacy". Clin. Exp. Allergy. 35 (4): 408–16. doi:10.1111/j.1365-2222.2005.02191.x. PMID 15836747. S2CID 6504882.
    26. 1 2 Holgate S, Casale T, Wenzel S, Bousquet J, Deniz Y, Reisner C (March 2005). "The anti-inflammatory effects of omalizumab confirm the central role of IgE in allergic inflammation". The Journal of Allergy and Clinical Immunology. 115 (3): 459–65. doi:10.1016/j.jaci.2004.11.053. PMID 15753888.
    27. ↑ Holgate S, Smith N, Massanari M, Jimenez P (December 2009). "Effects of omalizumab on markers of inflammation in patients with allergic asthma". Allergy. 64 (12): 1728–36. doi:10.1111/j.1398-9995.2009.02201.x. PMID 19839977. S2CID 205404340.
    28. ↑ van der Ent CK, Hoekstra H, Rijkers GT (March 2007). "Successful treatment of allergic bronchopulmonary aspergillosis with recombinant anti-IgE antibody". Thorax. 62 (3): 276–7. doi:10.1136/thx.2004.035519. PMC 2117163. PMID 17329558.
    29. ↑ Kontou-Fili K, Filis CI, Voulgari C, Panayiotidis PG (June 2010). "Omalizumab monotherapy for bee sting and unprovoked "anaphylaxis" in a patient with systemic mastocytosis and undetectable specific IgE". Ann Allergy Asthma Immunol. 104 (6): 537–9. doi:10.1016/j.anai.2010.04.011. PMID 20568389.
    30. 1 2 Fairley JA, Baum CL, Brandt DS, Messingham KA (March 2009). "Pathogenicity of IgE in autoimmunity: successful treatment of bullous pemphigoid with omalizumab". The Journal of Allergy and Clinical Immunology. 123 (3): 704–5. doi:10.1016/j.jaci.2008.11.035. PMC 4784096. PMID 19152970.
    31. ↑ Lee J, Doggweiler-Wiygul R, Kim S, Hill BD, Yoo TJ (May 2006). "Is interstitial cystitis an allergic disorder?: A case of interstitial cystitis treated successfully with anti-IgE". Int. J. Urol. 13 (5): 631–4. doi:10.1111/j.1442-2042.2006.01373.x. PMID 16771742. S2CID 34830352.
    32. ↑ Sands MF, Blume JW, Schwartz SA (October 2007). "Successful treatment of 3 patients with recurrent idiopathic angioedema with omalizumab". The Journal of Allergy and Clinical Immunology. 120 (4): 979–81. doi:10.1016/j.jaci.2007.07.041. PMID 17931567.
    33. ↑ de Llano LP, Vennera Mdel C, Álvarez FJ, Medina JF, Borderías L, Pellicer C, González H, Gullón JA, Martínez-Moragón E, Sabadell C, Zamarro S, Picado C; Spanish Registry (April 2013). "Effects of omalizumab in non-atopic asthma: results from a Spanish multicenter registry". J Asthma. 50 (3): 296–301. doi:10.3109/02770903.2012.757780. PMID 23350994. S2CID 26426416.{{cite journal}}: CS1 maint: multiple names: authors list (link)
    34. ↑ Lommatzsch M, Korn S, Buhl R, Virchow JC (May 2013). "Against all odds: anti-IgE for intrinsic asthma?". Thorax. 69 (1): 94–6. doi:10.1136/thoraxjnl-2013-203738. PMC 3888607. PMID 23709757.
    35. ↑ Maurer M, Rosén K, Hsieh HJ, Saini S, Grattan C, Gimenéz-Arnau A, Agarwal S, Doyle R, Canvin J, Kaplan A, Casale T (March 2013). "Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria". N Engl J Med. 368 (10): 924–35. doi:10.1056/NEJMoa1215372. PMID 23432142. S2CID 205095225.
    36. ↑ Kaplan A, Ledford D, Ashby M, Canvin J, Zazzali JL, Conner E, Veith J, Kamath N, Staubach P, Jakob T, Stirling RG, Kuna P, Berger W, Maurer M, Rosén K (July 2013). "Omalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy". The Journal of Allergy and Clinical Immunology. 132 (1): 101–9. doi:10.1016/j.jaci.2013.05.013. PMID 23810097.
    37. ↑ Kashiwakura J, Otani IM, Kawakami T (2011). "Monomeric IgE and mast cell development, survival and function". Mast Cell Biology. Adv Exp Med Biol. Advances in Experimental Medicine and Biology. Vol. 716. pp. 29–46. doi:10.1007/978-1-4419-9533-9_3. ISBN 978-1-4419-9532-2. PMID 21713650.
    38. ↑ "Le site de Novartis Huningue regroupe 2 unités". Novartis Biotech. Archived from the original on 2012-01-26. Retrieved 2012-07-23.
    39. ↑ "Community register of medicinal products for human use". ec.europa.eu. Archived from the original on 2014-04-20.
    40. ↑ Chen, SS; Katz, D. H. (1 February 1983). "IgE class-restricted tolerance induced by neonatal administration of soluble or cell-bound IgE". J Exp Med. 157 (2): 772–88. doi:10.1084/jem.157.2.772. PMC 2186933. PMID 6600492.
    41. ↑ Chen, SS; Liu, F. T.; Katz, D. H. (1 October 1984). "IgE class-restricted tolerance induced by neonatal administration of soluble or cell-bound IgE. Cellular mechanisms". J Exp Med. 160 (4): 953–70. doi:10.1084/jem.160.4.953. PMC 2187471. PMID 6237166.
    42. ↑ Chen SS (February 1992). "Genesis of host IgE competence: perinatal IgE tolerance induced by IgE processed and presented by IgE Fc receptor (CD23)-bearing B cells". Eur J Immunol. 22 (2): 343–8. doi:10.1002/eji.1830220209. PMID 1531635. S2CID 25625576.
    43. ↑ Haba, S; Nisonoff, A (30 June 1987). "Induction of high titers of anti-IgE by immunization of inbred mice with syngeneic IgE". Proceedings of the National Academy of Sciences of the United States of America. 84 (14): 5009–5013. Bibcode:1987PNAS...84.5009H. doi:10.1073/pnas.84.14.5009. PMC 305236. PMID 2440038.
    44. 1 2 Twombly R. Couple Lead Quest for New Allergy Drug. The Scientist January 7, 1991. http://www.the-scientist.com/?articles.view/articleNo/11548/title/Couple-Lead-Quest-For-New-Allergy-Drug/ Archived 2016-08-27 at the Wayback Machine.
    45. ↑ Development and Licensing Agreement, between Tanox and Ciba-Geigy 1990. "Development and Licensing Agreement - Tanox Biosystems Inc. And Ciba-Geigy Ltd. - Sample Contracts and Business Forms". Archived from the original on 2013-05-16. Retrieved 2013-07-04.
    46. ↑ Chang TW, Davis FM, Sun NC, Sun CR, MacGlashan DW Jr, Hamilton RG (February 1990). "Monoclonal antibodies specific for human IgE-producing B cells: a potential therapeutic for IgE-mediated allergic diseases". Bio/Technology. 8 (2): 122–6. doi:10.1038/nbt0290-122. PMID 1369991. S2CID 10510009.
    47. ↑ Davis FM, Gossett LA, Pinkston KL, Liou RS, Sun LK, Kim YW, Chang NT, Chang TW, Wagner K, Bews J, Brinkmann V, Towbin H, Subramanian N, Heusser C (1993). "Can anti-IgE be used to treat allergy?". Springer Semin. Immunopathol. 15 (1): 51–73. doi:10.1007/BF00204626. PMID 8362344. S2CID 32440234.
    48. ↑ Corne J, Djukanovic R, Thomas L, Warner J, Botta L, Grandordy B, Gygax D, Heusser C, Patalano F, Richardson W, Kilchherr E, Staehelin T, Davis F, Gordon W, Sun L, Liou R, Wang G, Chang TW, Holgate S (March 1997). "The effect of intravenous administration of a chimeric anti-IgE antibody on serum IgE levels in atopic subjects: efficacy, safety, and pharmacokinetics". J Clin Invest. 99 (5): 879–87. doi:10.1172/JCI119252. PMC 507895. PMID 9062345.
    49. ↑ Racine-Poon A, Botta L, Chang TW, Davis FM, Gygax D, Liou RS, Rohane P, Staehelin T, van Steijn AM, Frank W (December 1997). "Efficacy, pharmacodynamics, and pharmacokinetics of CGP 51901, an anti-immunoglobulin E chimeric monoclonal antibody, in patients with seasonal allergic rhinitis". Clin Pharmacol Ther. 62 (6): 675–90. doi:10.1016/S0009-9236(97)90087-4. PMID 9433396. S2CID 28652703.
    50. ↑ Presta LG, Lahr SJ, Shields RL, Porter JP, Gorman CM, Fendly BM, Jardieu PM (September 1993). "Humanization of an antibody directed against IgE". Journal of Immunology. 151 (5): 2623–32. PMID 8360482.
    51. 1 2 Thorpe H. Drug war. (small drug firm Tanox takes on Genentech over patent rights) Texas Monthly, April 1, 1995. https://web.archive.org/web/20131029193124/http://business.highbeam.com/410545/article-1G1-16816180/drug-war. Archived from the original on 2013-10-29. {{cite web}}: Missing or empty |title= (help)
    52. ↑ The family of anti-IgE patents. "Methods for producing high affinity anti-human IgE-monoclonal antibodies which binds to IgE on IgEabearing B cells but not basophils". Archived from the original on 2014-03-19. Retrieved 2012-09-30.; "Chimeric anti-human IgE-monoclonal antibody which binds to secreted IgE and membrane-bound IgE expressed by IgE-expressing B cells but notto IgE bound to FC receptors on basophils". Archived from the original on 2014-03-19. Retrieved 2012-06-23.; "Monoclonal antibodies that bind to soluble IGE but do not bind IGE on IGE expressing B lymphocytes or basophils". Archived from the original on 2014-03-19. Retrieved 2012-09-30.; "Treating hypersensitivities with anti-IGE monoclonal antibodies which bind to IGE-expressing B cells but not basophils". Archived from the original on 2014-03-19. Retrieved 2012-06-23.; "Humanized monoclonal antibodies binding to IgE-bearing B cells but not basophils". Archived from the original on 2014-02-21. Retrieved 2012-06-23..
    53. 1 2 Tripartite Cooperation Agreement, by and between NOVARTIS PHARMA AG, GENENTECH, INC, AND TANOX, INC. "Tripartite Cooperation Agreement". Archived from the original on 2016-08-22. Retrieved 2017-09-07.
    54. ↑ "Genentech: Press Releases - Genentech Announces Agreement to Acquire Tanox for $20 Per Share". www.gene.com. Archived from the original on 2013-07-06.
    55. ↑ "Genentech completes acquisition / $919 million for Tanox is its first purchase ever". 2007-08-03. Archived from the original on 2016-04-14.
    56. ↑ "Asthma drug ruling 'nonsensical'". BBC News. August 12, 2010. Archived from the original on August 12, 2010.
    57. ↑ NICE says yes to treatment for asthma in final draft guidance. NICE March 7, 2013. "News". Archived from the original on 2013-03-12. Retrieved 2013-07-07.
    58. ↑ Sheldon, T (23 August 2013). "Senior Dutch researcher sacked for manipulating data in rheumatoid arthritis drug trial". BMJ (Clinical Research Ed.). 347: f5267. doi:10.1136/bmj.f5267. PMID 23974641. S2CID 42283648.
    59. ↑ Davydov, L (15 January 2005). "Omalizumab (Xolair) for treatment of asthma". American Family Physician. 71 (2): 341–2. PMID 15686303. Archived from the original on 23 January 2021. Retrieved 15 July 2021.
    External sites:
    Identifiers:
    This article is issued from Offline. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.