Xolair

[zzrzof]

I have had COPD, namely Emphasema, for several years. In April 2007, I developed what my Dr thinks is pneumonia...he termed it "a very large pneumonia"...it spread into the other lobe and I was hospitalized for about 3 weeks (including rehab). I have been on oxygen theraphy since then for 24 hrs a day...I deplete quickly upon any exertion, but also recover quickly when at rest...I keep the Oxygen level at 1 during rest and 2+ during activity...My Dr. would like my oxy levels to be between
90 and 94...it is very difficult to maintain those levels with any consistancy.  I have had several CT scans, and many xrays, and the most recent in July 2007 showed a little improvement in the masses in my lungs (i.e. it seemed to be breaking up, but by and large these masses are still there....My Dr doesn't think that it is a true pneumonia (I never ran a temp)...and doesn't know what it is...I had that broncial test where tubes are put into my lungs for biopsies (I can't remember the name of the procedure) and it did not prove cancerous at that time...My question....I just recently heard about XOLAIR...if the required criteria is met...can it be used to treat Emphesema?  I thank you for your opinions and expertise.....zzr

[National Jewish Health]

I am sorry, but there is absolutely no benefit in treating emphysema with Xolair® (omalizumab).  Xolair® (omalizumab) is specifically designed for the treatment of a number of allergic diseases, including asthma.  Your description of your illness suggests that you have not had and do not now have infectious pneumonia.  It is very good news that the biopsy of the "masses", which I suspect we would call "infiltrates", did not show cancer.  However the real question remains what else did it show or not show.  If you are to have any chance for treatment and improvement, a diagnosis must be established.  If as you imply, the biopsies did not answer the question, then you should have another biopsy, what we call an open lung biopsy, rather than the type you had done through the "tube" called a bronchoscope.  It is likely that yours is a non-infectious pneumonia, of which there are a number, including hypersensitivity pneumonitis, sarcoidosis and bronchiolitis obliterans with organizing pneumonia (BOOP).  You might want to ask your doctors if these are possibilities.

You should also ask your pulmonary specialist what he believes to be the most likely diagnosis and if it is treatable.  If he can't answer your question, you might want to get a second opinion.

Good luck