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This article is part of the supplement: Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2012

Open Access Open Badges Meeting abstract

Measured depth of subcutaneous tissue on posterolateral arm of omalizumab patients

Ryan Potts1, Laura Kim2, Clark Eeuwes3, Arunmozhi Dominic3, Immaculate Nevis4 and Harold L Kim34*

Author Affiliations

1 University of Waterloo, Waterloo, Ontario, Canada

2 McGill University, Montréal, Québec, Canada

3 University of Western Ontario, London, Ontario, Canada

4 McMaster University, Hamilton, Ontario, Canada

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Allergy, Asthma & Clinical Immunology 2012, 8(Suppl 1):A5  doi:10.1186/1710-1492-8-S1-A5

The electronic version of this article is the complete one and can be found online at:

Published:2 November 2012

© 2012 Potts et al; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Omalizumab is a humanized antibody utilized for patients with moderate/severe allergic asthma. There is an estimated risk of anaphylaxis to omalizumab in 0.1% of patients. Omalizumab should be received in the subcutaneous tissue of the mid-posterolateral upper arm. There may be an increased risk of anaphylaxis if injections are received intramuscularly (IM). In our clinic, omalizumab is given with BD Eclipse™ Needle, which is routinely provided with the drug and has needle length 16mm. If a patient has a skin to muscle depth (STMD) less than 16mm, there is a risk of omalizumab being injected IM.


We reviewed charts in an allergy clinic where an ultrasound of the left posterolateral arm was completed to measure STMD. Patients were divided into two groups based on their STMD (>16 mm and ≤16 mm) and baseline characteristics were compared. We conducted multivariable linear regression with age, sex, BMI and race. The percentages of patients with STMD greater than 4 mm, 6 mm, 8 mm, 10 mm, and 12 mm were determined.


Ultrasounds were completed on 40 patients receiving omalizumab. Three (7.5%) patients examined had >16 mm of STMD. Baseline characteristics were consistent between the groups except for BMI (p < 0.05). Sex and BMI correlated with STMD based on the linear regression analysis. Also, 35 (87.5%) patients had >4 mm STMD.


With provided omalizumab needles, the risk of anaphylaxis may be increased as the injections may be given IM. By reducing the needle length to 4 mm, the risk will likely be reduced.