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Omalizumab (Xolair®) is a recombinant humanized IgG1 kappa monoclonal anti-IgE antibody. It has been marketed since 2003 as additional treatment for severe persistent allergic asthma in adults, adolescents and children (aged 6 up to 11 years).
Its mechanism of action has not been clearly elucidated in chronic urticaria. It binds to free IgE inhibiting the interaction of IgE with the high-affinity IgE receptor (FcεRI). This inhibition leads to a rapid decrease in the serum of free IgE levels after administration of omalizumab. Furthermore, omalizumab reduces the number of FcεRI receptors on basophils.
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