More than half of children in an early-stage study successfully ate foods they were previously allergic to one year after discontinuing Xolair, a medication used for certain food allergies. The findings offer hope for families managing food allergies but come with important cautions from medical experts.
Encouraging Findings from a Nationwide Study
The study followed 60 children who had undergone at least 24 weeks of treatment with Xolair (omalizumab), tracking their ability to eat allergenic foods after stopping the medication. Each child followed three treatment plans, with 82% of these plans involving the supervised consumption of an allergy-triggering food.
After one year, researchers found that:
- 61-70% of children successfully ate milk, egg, or wheat.
- 38-56% were able to consume peanuts or tree nuts.
These preliminary findings were presented on March 2 by Dr. Jennifer Danzer, a pediatric allergist at Johns Hopkins Children’s Center, during a symposium at the American Academy of Allergy, Asthma & Immunology and World Allergy Organization Joint Congress in San Diego.
“While the results of Stage 3 are still preliminary, the majority of the first 60 participants were able to successfully introduce allergenic foods into their diet after stopping omalizumab,” Dr. Danzer stated in a Johns Hopkins press release.
Potential Benefits and Risks of This Approach
Xolair, a lab-made monoclonal antibody, works by targeting IgE, a key allergy trigger. Originally approved by the U.S. Food and Drug Administration (FDA) for asthma, it recently gained approval in February 2024 to reduce allergic reactions from accidental exposure. However, its use while intentionally consuming allergens is not yet FDA-approved, though it can be considered under medical supervision.
Researchers emphasized that success with this approach is not guaranteed for all children. Some experienced treatment failure due to:
- Taste or food aversion.
- Allergic reactions.
- Two cases of eosinophilic esophagitis, leading to discontinued treatment.
The study tested several common allergens, including peanut, cashew, egg, milk, walnut, hazelnut, and wheat. Success was defined as the ability to consume at least 300mg of the food daily without significant allergic reactions.
Xolair vs. Oral Immunotherapy: Comparing Treatments
The findings from this study coincide with another report presented at the same conference, comparing Xolair with oral immunotherapy (OIT), a common treatment that gradually exposes patients to increasing amounts of an allergen to build tolerance.
Dr. Robert Wood, director of the Eudowood Division of Allergy, Immunology, and Rheumatology at Johns Hopkins Children’s Center and lead researcher in the study, explained:
“We hypothesized that while Xolair was still in the system, rapid desensitization could occur, and for the majority of participants, this turned out to be possible.”
While preliminary data suggests that Xolair may offer advantages over oral immunotherapy, both options remain viable treatment strategies. However, doctors stress that neither therapy guarantees long-term success.
The Need for Ongoing Food Exposure
Doctors involved in the study believe that children who successfully reintroduce allergenic foods into their diets must maintain consistent, near-daily exposure to prevent the allergy from returning. This requirement applies to both Xolair-assisted desensitization and oral immunotherapy.
Dr. Sharon Chinthrajah, an associate professor at Stanford Medicine and senior study author, emphasized that treatment decisions should be individualized:
“There is no one-size-fits-all therapy. Families and patients should carefully consider their goals—whether it’s being able to eat a specific food safely or reducing the risk of severe reactions from accidental exposure.”
Next Steps and Final Thoughts
While this research provides encouraging insights, the study is ongoing, and researchers continue to collect data to better guide doctors in developing personalized treatment plans.
Dr. Danzer acknowledged that some allergists already use this approach for select patients, despite it not being officially FDA-approved for intentional allergen consumption:
“We and others are already using this approach for select patients with caution, recognizing that this use is not consistent with the FDA label.”
Doctors warn that even with successful desensitization, allergic reactions remain a possibility, and Xolair itself can cause severe allergic responses. Additionally, its injections can be painful.
Parents interested in exploring this treatment option should consult an allergy specialist to determine whether their child may benefit from this emerging approach.
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