A major breakthrough in protection against severe allergies could have been made after a study found an asthma drug to increase allergen tolerance.

The study by The New England Journal of Medicine found that Omalizumab reduced the frequency of severe reactions in multi-food allergic participants – mostly children aged one to 17.

After a four-month course of the drug, two thirds of those involved could consume a dose of peanut protein equivalent to two to three peanuts, compared to just seven per cent of the participants taking a placebo.

So, with the U.S. Food and Drug Administration (FDA) approving the use of omalizumab for the reduction of allergic reactions in February 2024, how does the drug work? 

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

Omalizumab, commonly known as Xolair, has been shown to improve participants' responses to food allergens including peanuts in a New England Journal of Medicine study

Omalizumab, commonly known as Xolair, has been shown to improve participants’ responses to food allergens including peanuts in a New England Journal of Medicine study

The study was conducted on mostly children with multiple food allergies, and also had similar positive results around reactions to milk and eggs (stock image)

The study was conducted on mostly children with multiple food allergies, and also had similar positive results around reactions to milk and eggs (stock image)

What is omalizumab? 

Omalizumab, sold under the branded 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 lining of the nose and sinuses.

The drug is delivered 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 given protein as a threat, but when someone is allergic to a protein the antibody can cause unnecessary inflammation, which leads to the reactions we see externally. 

In attacking the antibody, omalizumab can guard against unnecessary inflamation and anaphylactic shock.

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

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

Can omalizumab cure food allergies?

While the results from The New England Journal of Medicine were very promising, there is no suggestion that Xolair can be rolled out as a catch-all cure.

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

The results only go as far as to show that omalizumab raises the threshold of a food allergen which can be withstood by someone who is allergic to it, rather than curing the allergy altogether.

As a result, those who take the drug would still be instructed to be careful to avoid the foods to which they are allergic.

The study’s lead author Robert Wood said the ‘biggest worry’ would be people ‘assuming that their protection from food reactions is pretty complete’.

It is also not approved for the treatment of allergic reactions themselves once they have happenned. 

How are food allergies treated?

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

OIT involves the allergy sufferer ingesting incrementally larger amounts f the food to which they are allergic every day until they can tolerate a usual dose.

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

Palforzia is a peanut protein powder which replicates OIT in allowing those who take it to build their resilience over time – but is only available to children aged four and over.

Contrastingly, the study into omalizumab reported positive results in children as young as one year old. 

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