By Food allergies are a serious and potentially life-threatening condition that affects millions of children and adults around the world. For those who are allergic to multiple foods, such as peanuts, eggs, milk, or wheat, avoiding accidental exposure can be challenging and stressful. However, a new study suggests that a drug that is commonly used to treat asthma and hives may offer some protection and relief for people with food allergies.
The drug, called omalizumab, or Xolair, is an injectable medication that targets the immune system. It binds to and inactivates a type of antibody called immunoglobulin E (IgE), which is responsible for triggering allergic reactions. By reducing the levels of IgE in the blood, Xolair can prevent or lessen the inflammation and symptoms that occur when someone with food allergies eats a small amount of their allergen.
Xolair was first approved by the U.S. Food and Drug Administration (FDA) in 2003 to treat allergic asthma, a condition in which the airways become narrow and inflamed due to exposure to allergens. In 2014, the FDA expanded the approval of Xolair to include chronic hives, a skin condition that causes red, itchy, and swollen bumps. On Feb. 16, 2024, the FDA approved Xolair for the treatment of food allergies in children as young as one year old and adults. It is the first drug that can treat allergies to multiple foods.
What the study found
The study, published in the New England Journal of Medicine, was led by researchers from Stanford University and Johns Hopkins University. It involved 225 participants, aged 4 to 55, who had severe allergies to peanuts and at least two other foods, such as eggs, milk, tree nuts, sesame, or wheat. The participants were randomly assigned to receive either Xolair injections or placebo injections for 16 weeks. They also underwent oral food challenges, in which they were given increasing doses of their allergens until they developed a reaction.
The results showed that Xolair significantly increased the amount of allergen that the participants could tolerate before having a reaction. For example, the median dose of peanut that triggered a reaction increased from 10 mg to 144 mg in the Xolair group, compared to 10 mg to 24 mg in the placebo group. The Xolair group also had fewer and milder reactions than the placebo group. The most common side effects of Xolair were injection site reactions, headache, and abdominal pain.
What it means for food allergy patients
The study authors say that Xolair is not a cure for food allergies, and that patients still need to avoid their allergens and carry epinephrine, an emergency medication that can reverse anaphylaxis, a severe allergic reaction that can cause difficulty breathing, low blood pressure, and loss of consciousness. However, they say that Xolair can provide an extra layer of protection and peace of mind for food allergy patients and their families, especially in situations where they may encounter unknown or contaminated foods, such as at parties, restaurants, or schools.
Dr. R. Sharon Chinthrajah, the co-lead author of the study and the acting director of the Sean N. Parker Center for Allergy and Asthma Research at Stanford University, said in a press release: “This is a major breakthrough for food allergy, as omalizumab affords food allergy families improved quality of life and safety when doing everyday activities. We are hopeful that this will be a game-changer for the food allergy community.”