Xolair may help patients from accidental exposure
By Deborah Jeanne Sergeant
Food allergies can cause serious, life-threatening reactions such as anaphylaxis upon exposure. The FDA recently approved Xolair (omalizumab) for people age older than 1 for reducing food allergy reactions.
Anaphylaxis is when the patient’s immune system releases chemicals to cause the body to go into shock. The blood pressure plummets. The person struggles to breathe and presents with a fast but weak pulse, flushed skin and possibly nausea and vomiting. Administering epinephrine is lifesaving and the patient should go to an emergency room as a follow-up.
Although people who have life-threatening food allergies should avoid exposure to allergenic food, Xolair can help reduce the reaction in case of accidental exposure.
Xolair is not a new medication; it’s been used for asthma treatment since 2003.
“Anaphylaxis or life-threatening allergic reactions, is often mediated by an IgE antibody,” said Haidy Marzouk, ENT/otolaryngologist and allergist at St. Joseph’s Health. “Studies found that treatment with omalizumab reduced severe reactions in people who had accidental exposure to foods they were severely allergic to in small amounts in comparison to placebo.”
Patients receive an injection every two to four weeks. They can receive the injection at a doctor’s office or administer it themselves at home. Marzouk explained that it works by blocking the immunoglobulin E (IgE). The immune system produces this antibody, a protein, as a response to a possible attacker but mistakes harmless foods as invaders.
Xolair works by increasing the amount of allergen required to trigger a reaction such as anaphylaxis.
“It is not a cure for food allergies and does not replace the need to carry an EpiPen and use it when necessary,” Marzouk said. “It is only shown to reduce risk of life-threatening reaction with accidental
exposure.”
The side effects are minimal. Xolair has no contraindications and has shown 0.1% risk of side effects in children, including mild injection site pain and fever. None of the reactions were severe enough to warrant discontinuation of the medication. Reaction data among adults is limited.
People interested in Xolair for themselves or their children should discuss the medication with their healthcare provider.
Another recent advance in food allergies is oral immunotherapy for young children. This involves gradually increasing exposure to reduce reaction extremes and potentially introducing the food to their diet. Oral immunotherapy could possibly mean that eventually, the allergy could be minimized in its effect or even eliminated. But this type of therapy should only be undertaken with a healthcare provider’s approval and guidance.