Xolair

[M-D-F]

I have just had my third injection of this trial. My peak flow this morning was 170 at the hospital, and now 220, this includes three days of prenisolone.

Question is what is the next options after xolair?

[Minushabens]

I guess it's hard to say what the next step might be as it will depend a little on the individual doctor. My (new) consultant has taken an approach of continuously increasing strength & dosage of my medicines (he calls it his "throw everything at it" approach) to the point that I rattle in the morning, so they might opt for longer-term steroid use or just a different inhaler regime perhaps?

[M-D-F in reply to Minushabens]

Cheers I just wondered what the next step would be, I was wondering what there is after xolair.

[Lysistrata Administrator Community Ambassador]

The idea of using newer drugs like Xolair is to cut down on long term steroids and when existing regimes don't work. If Xolair doesn't work, I should think they might look at trying one of the newer injectable treatments like mepolizumab, if you meet those criteria. Not all asthmatics have high eosinophil levels drivijf their asthma but I think it's more common than having the IgE.levels for Xolair. I'd.imagine they might look at testing to see.if mepolizumab could work. You may need a washout in between the drugs if you do get mepolizumab, but if Xolair isn't really working for you then hopefully being off it at least will not be worse!

Disclaimer or not being on these drugs (was assessed, wrong type.of asthma for current ones) - you could ask the AUK nurses for more details?

[M-D-F]

Thanks, xolair seemed to work moderately for the first trail, my peak flow stays at about 170 in the mornings, which doesn't allow me to go up stairs in one go!

[Joan_Public]

Hi, interesting to hear your experience of xoliar and how you have responded. Sorry that you are struggling and that it does not appear to be giving you the benefits you hoped for.

I had my first xoliar injection last week. Nurse said she thought mepolizumab would be better option for me, but to try xoliar first as it is a shorter trial period. They do a test to check if your blood shows above a certain level of white blood cells (eosinophills. ?sp?) and if it does, then you are eligible to try mepolizumab.

As you know already, they tried you with the xoliar because your blood tests showed raised IgE indicating an allergic element to your asthma. If you have both raised igE and raised eoisinophills and you fit the categories for xoliar and melpolizumab, they like try Xoliar first. So, hopefully, you will get to try mepolizumab if xolair hasn't helped your asthma. Otherwise, it is daily oral steroids tablets ... or increased dose if you are already on this option.

Since beginning xoliar 6 days ago, my pf has gone down to 190 from around 280. I am having to take the stairs very slowly ... Had a brycanyl neb yesterday pm so pf up to 380 after that, but back down to 190 this morning. Also, I have felt light headed and weak (sort of like a low blood sugar feeling) since starting it. Really hope this feeling passes ...

[M-D-F]

thank for your input into my life. There is a bug going around at the moment (Birmingham) which might account for half my low PF and perhaps your lowness.

I always have a headache during the two wait after the injections, but it is brief "bang" then it is gone. Others in the waiting area complain/remark on a feeling of tiredness to various degrees, and seem to be the exception to the miraculous cure.

I hope it helps your asthmatic conditions.

Unless you raise an objection I would like to follow your posts.

[Joan_Public]

I also was wondering if its a bug making me feel worse as I felt I was going down before I started the xoliar...

It is helpful to hear the experience of others on this med. I was hoping that I might meet someone else at the hosp, but did not get the opportunity, as I was just in the general cardio/resp waiting area and was then called in very quickly. There was no waiting around after receiving the injection either, which is something I had been expecting from reading on the internet about what to expect. I was given an information book / diary and an epipen in case of a serious reaction and the whole appointment was only about 20 mins.

I guess if you have had 4 shots now you will be up for review when you next go in. So this would be a good time for you to ask about whether you are eligible to try mepolizumab if you haven't felt the xoliar has given you any significant improvements. Have you had to keep a diary while receiving the xoliar? Nurse said they decide whether to continue with xoliar depending on FeNo test and quality of life questionnaire scores.

Have you needed extra steroids at all in the 4 months while you've been on it?

I don't have any objections to you following my posts, but I don't post that often.

[M-D-F]

Thanks for yr reply, other people tell of the improvement, and the nurses hint that the next step would be injections twice a month, time will tell.

Best of luck to you and your son.