What is omalizumab? The asthma drug that research shows could prevent allergic reactions to food

A major breakthrough in protection against severe allergies could have happened after a study found that an asthma drug increases allergen tolerance.

The New England Journal of Medicine study found that Omalizumab reduced the frequency of severe reactions in participants allergic to multiple foods – especially children aged 1 to 17 years.

After a four-month course of the drug, two-thirds of those involved were able to consume a dose of peanut protein equivalent to two to three peanuts, compared to only seven percent of participants who took a placebo.

How does the drug work now that the US Food and Drug Administration (FDA) approves the use of omalizumab for the reduction of allergic reactions in February 2024?

Read on to learn more about omalizumab and how food allergies can be treated.

The study was conducted primarily in children with multiple food allergies and also had similarly positive results in terms of reactions to milk and eggs (stock image)

What is omalizumab?

Omalizumab, sold under the brand name Xolair, was first approved by the FDA in 2003 as an asthma treatment aimed at improving moderate and severe asthma.

It has since been approved in both Europe and America as a treatment for hives and nasal polyps – inflamed linings of the nose and sinuses.

The drug is given as an injection every two to four weeks and targets a specific antibody called IgE.

IgE – like other human antibodies – is produced when the immune system perceives a particular protein as a threat, but when someone is allergic to a protein the antibody can cause unnecessary inflammation, leading to the reactions we see externally.

By attacking the antibody, omalizumab can protect against unnecessary inflammation and anaphylactic shock.

Omalizumab is given as an injection every two to four weeks and targets a specific antibody called IgE (stock image)

Can omalizumab cure food allergies?

Although the results from The New England Journal of Medicine were promising, there is no suggestion that Xolair can be rolled out as a comprehensive cure.

Although no adverse side effects were found, a third of those taking the drug still experienced severe reactions to peanut protein test levels – and similar results were seen with other allergens such as milk, eggs and some other tree nuts.

The results only go so far as to show that omalizumab increases the threshold of a food allergen that can be resisted by someone allergic to it, rather than curing the allergy altogether.

As a result, those taking the drug would still be instructed to be careful about avoiding the foods they are allergic to.

The study’s lead author, Robert Wood, said the “biggest concern” would be that people “assume that their protection against food reactions is quite complete.”

It is also not approved for treating allergic reactions themselves after they have occurred.

How are food allergies treated?

Before the approval of Xolair to combat food allergies in the United States, oral immunotherapy (OIT) was the only recognized treatment for food allergies.

OIT involves people with allergies taking incrementally larger amounts of the food they are allergic to each day until they can tolerate a usual dose.

The FDA also approved a treatment specific for peanut allergies in 2020 called Palforzia.

Palforzia is a peanut protein powder that replicates OIT, helping those who use it build their resilience over time – but it’s only available for children aged four and over.

In contrast, the omalizumab study reported positive results in children as young as one year old.