Self-administration of omalizumab: why not? A literature review and expert opinion.

Menzella, Francesco; Ferrari, Emanuele; Ferrucci, Silvia Mariel; Lombardi, Enrico; Alfano, Silvio; Bonavita, Ornella; Morini, Paolo; Rizzi, Andrea; Matucci, Andrea

INTRODUCTION : Omalizumab is used to treat severe uncontrolled allergic asthma and chronic spontaneous urticaria (CSU), and is approved for self-administration in prefilled syringes. It is thus important to understand the advantages, critical issues, and indications for home administration. AREAS COVERED : The present review summarizes the available evidence on home administration of omalizumab in asthma and CSU to illustrate the advantages derived from self-administration of patients in this setting. EXPERT OPINION : The available data suggest that patients can safely administer biologics at home with suitable training, and that home administration is time saving and cost effective. The majority of patients with severe asthma or CSU treated with omalizumab are likely to be suitable candidates for self-administration, which can be proposed to anyone that the clinician deems suitable. In addition to clinicians, pharmacists can also play a key role in managing patients who are prescribed home administration. A practical flow chart is proposed on selection of patients and their management during home administration. Self-administration of biologics can be considered as a valid alternative to traditional injections in a clinical setting, and the evidence has shown that no major issues need to be overcome in terms of safety or efficacy.