This Asthma Drug Can Prevent Severe Food Allergies from Peanuts, Milk, and Eggs

Fact checked by Nick Blackmer

Key Takeaways

• The FDA has approved Xolair to help prevent allergic reactions in people with severe food allergies.

• The medication is an injection that’s taken every two or four weeks. It’s available by prescription for people with immunoglobulin E-mediated food allergies, specifically.

• Xolair comes with the risk of a few side effects, including joint pain, fever, and anaphylaxis.

The Food and Drug Administration (FDA) has approved the first medication for the reduction of allergic reactions that can happen with accidental exposure to certain foods.

Xolair (omalizumab) is a monoclonal antibody that can lower the risk of anaphylaxis in people with severe food allergies. It works by binding to immunoglobulin E (IgE), the antibody type that triggers allergic reactions. In doing so, it also blocks IgE from binding to its receptors, lowering the risk of an allergic reaction in the process.

The medication is given by injection every two to four weeks.

Another oral medication, Palforzia (peanut powder), is approved for use in people between the ages of 4 and 17 to lower the risk of allergic reactions, but it’s limited to peanut allergies. Xolair is available by prescription for ages 1 and up.

“While it will not eliminate food allergies or allow patients to consume food allergens freely, its repeated use will help reduce the health impact if accidental exposure occurs,” Kelly Stone, MD, PhD, associate director of the Division of Pulmonology, Allergy, and Critical Care in the FDA’s Center for Drug Evaluation and Research, said in a statement.

While Xolair’s recent approval is to prevent severe allergic reactions, the drug was originally approved in 2003 to treat moderate to severe persistent allergic asthma. It’s also approved to treat chronic and spontaneous hives (urticaria) and chronic sinus infections with nasal polyps.

In a phase 3 clinical trial, 68% of study participants who were allergic to peanuts and at least two other foods were able to eat a single dose of peanut protein without experiencing moderate or severe allergic symptoms that impacted the skin, respiratory, or gastrointestinal system, compared to 6% of those who received a placebo.

But 17% of people who received Xolair had no significant change in how much peanut protein they could tolerate, which is why the FDA still recommends avoiding allergens when patients are on the medication.

“If it works well for a patient, parents won’t have to worry so much about their child going to a friend’s house or birthday party, as well as what kids are sharing at lunch,” Daniel Ganjian, MD, a pediatrician at Providence Saint John’s Health Center in Santa Monica, California, told Verywell. “This will never make people love the food they’re allergic to, but at least they’ll be able to tolerate it a little more.”

Xolair also helped 42% of people tolerate cashews, 66% tolerate milk, and 67% tolerate eggs.

How to Take It

Once it’s prescribed, Xolair is given with the help of a prefilled syringe or autoinjector at home. Dosage varies from 75 to 600 milligrams every two to four weeks.

There are no reports of withdrawal issues when patients stop taking Xolair.

“This medication is for prevention only,” Jamie Alan, PharmD, PhD, an associate professor of pharmacology and toxicology at Michigan State University, told Verywell. “Xolair would not replace epinephrine injections like Epipens, and epinephrine injections should still be the drug of choice in an allergic reaction.”

Known Side Effects

There are a few potential side effects of taking Xolair. Those include the potential risk of:

• Injection site reactions

• Fever

• Anaphylaxis

• Cancer

• Joint pain

• Rash

• Parasitic infection

• Abnormal laboratory tests

Getting Xolair to Treat Your Severe Food Allergies

The cost of Xolair varies by dosage and whether you have health insurance.

“The estimated list price for Xolair for food allergy ranges from approximately $2,900 for children and $5,000 for adults each month; however, the actual cost paid by most patients is typically lower based on their insurance coverage and other financial assistance programs available,” a Genentech representative told Verywell. Genentech manufactures Xolair together with Novartis Pharmaceuticals. “Over the past 20 years, we are pleased that most patients have been covered by insurance for Xolair, and we are hopeful to work with payers to ensure similar coverage for food allergy patients.”

The Genentech Patient Foundation offers the medication for free for people who have been prescribed Xolair and don’t have insurance or who meet certain eligibility criteria.

Read the original article on Verywell Health.