Understanding Xolair: How It Works To Treat Food Allergies

What are food allergies?

Food allergies are immune system reactions that occur shortly after consuming certain foods. They can range from mild to severe and can cause a variety of symptoms, including digestive issues, skin rashes, swelling, difficulty breathing, and even life-threatening anaphylaxis. Common food allergens include peanuts, tree nuts, sesame seed,shellfish, eggs, milk, soy, wheat, and fish.

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Food allergy symptoms

The symptoms of a food allergy can vary widely from person to person and can range from mild to severe. 

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Mild symptoms may include:

• Itching, tingling, or swelling of the lips, tongue, or throat 
• Difficulty breathing
• Wheezing

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More severe symptoms include:

• Abdominal pain 
• Vomiting
• Diarrhea
• Anaphylaxis, a potentially life-threatening allergic reaction, requires immediate medical attention and may include symptoms such as difficulty breathing, a rapid drop in blood pressure, and loss of consciousness.

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If you experience any unusual or severe symptoms, it's crucial to seek medical attention promptly.

What is Xolair?

Xolair was originally approved in 2003 for the treatment of moderate to severe persistent allergic asthma in certain patients. Xolair is also approved to treat chronic urticaria and chronic rhinosinusitis with nasal polyps in certain patients.It works by targeting and inhibiting immunoglobulin E (IgE), a key player in the allergic response. By blocking IgE, Xolair helps decrease inflammation caused by allergies in the airways, making it easier to breathe. 

Xolair was granted approval by the Food and Drug Administration on February 16, 2024, for the purpose of reducing allergic reactions, including anaphylaxis, resulting from accidental exposure to one or more food allergens in both adults and children age 1 year and older who suffer from food allergies.

Xolair is the first FDA-approved medication to reduce allergic reactions to more than one type of food after accidental exposure.

Xolair, also known by its generic name omalizumab, is a prescribed injectable medication used to address food allergies in individuals aged one year and older, aiming to mitigate allergic reactions that may arise from accidental consumption of allergenic foods. It is crucial to continue avoiding all foods known to trigger allergic reactions while undergoing Xolair treatment. However, the safety and efficacy of Xolair have not been established for individuals under one year of age. Typically administered via subcutaneous injections, Xolair treatment involves receiving one or more injections under the skin every two or four weeks. Before initiating Xolair therapy for food allergies, individuals must undergo a blood test to assess levels of immunoglobulin E, a key factor in the allergic response. This comprehensive approach ensures that Xolair therapy is tailored to the individual's specific allergy profile and treatment needs.

Additional data should be coming that will allow Xolair to provide even more treatment options for food allergic individuals. There is hope that Xolair will be approved to use in combination with Oral Immunotherapy (OIT) in the near future. Preliminary studies combining Xolair and OIT allows for a more aggressive dosing escalation with a reduced risk of reaction. 

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Where is Xolair injected?

Xolair is typically administered via subcutaneous injection, meaning it is injected under the skin. The injections are usually given in the upper arm or thigh by a healthcare professional or can be self-administered at home in some cases. If you are given Xolair to take at home, you will be prepared with instructions on how to use it and inject it properly. It’s important to take it exactly as directed on the prescription label and to continue following your treatment plan with it until your provider says otherwise. 

Side effects of Xolair

Xolair, while generally well-tolerated, may cause side effects in some individuals. It's essential to be aware of these potential side effects and to promptly report any concerning symptoms to your healthcare provider. Common side effects and symptoms of Xolair may include:

• Redness, swelling, or pain at the injection site
• Nasal congestion
• Sore throat
• Headache
• Fatigue
• Dizziness
• Joint pain
• Nausea
• Skin rash
• Hives

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It's important to note that this is not a complete list, and individuals may experience different side effects. If you experience any unusual or severe symptoms after receiving Xolair injections, it's crucial to seek medical attention promptly. Additionally, discuss any concerns or side effects with your healthcare provider to ensure appropriate management and ongoing care.

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Where can I store my Xolair?

Xolair should be stored properly to maintain its stability and effectiveness. The medication should be kept refrigerated between 36°F to 46°F and protected from light. It should not be frozen. Once removed from the refrigerator, Xolair can be kept at room temperature for up to 30 days, as long as it is not exposed to temperatures above 77°F. It is crucial to store Xolair in its original carton to shield it from light. Additionally, Xolair should be kept out of the reach of children and pets. 

If the medication is not stored properly, its efficacy may be compromised, leading to potential treatment failures. Therefore, it is essential for patients to adhere to the recommended storage guidelines provided by their healthcare provider or pharmacist.

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How long does it take to start working?

The onset of action for Xolair varies among individuals and depends on several factors, including the severity of the allergic condition being treated and the individual's response to the medication. While some patients may experience relief shortly after starting treatment, it may take several weeks for others to notice significant improvements in their symptoms. It is essential for patients to adhere to their prescribed treatment regimen and follow up with their healthcare provider to monitor progress.

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What to expect after the first Xolair injection?

Following the first Xolair injections, patients may experience a range of reactions, including injection site reactions such as redness, swelling, or discomfort. These reactions are typically mild and transient. Some patients may also experience mild flu-like symptoms or headache after starting treatment, although these side effects tend to diminish over time as the body adjusts to the medication. It is crucial to report any adverse reactions or concerns to your healthcare provider promptly.

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What does Xolair do to your immune system?

Xolair works by targeting and inhibiting immunoglobulin E, a type of antibody that plays a central role in the allergic response. By blocking IgE, Xolair helps reduce the allergic inflammation and symptoms associated with conditions such as allergic asthma and food allergies. However, it is essential to note that Xolair does not suppress the entire immune system but rather specifically targets the allergic response.

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How long can you stay on Xolair?

The duration for which an individual can stay on Xolair treatment can vary depending on several factors, including the severity of their allergic condition, their response to the medication, and their healthcare provider's recommendations. It is expected that patients will need to remain on Xolair long term to continue to have a level of protection for accidental ingestions of food allergy. Discontinuation of Xolair would mean the individual would not have continued protection for allergic responses. Xolair is often prescribed as a long-term treatment for conditions such as allergic asthma and hives to help manage symptoms and improve quality of life. It is essential for patients to follow their healthcare provider's guidance regarding the duration of Xolair treatment and to attend regular follow-up appointments to monitor their progress and adjust their treatment plan as needed. Ultimately, the decision to continue or discontinue Xolair therapy should be made in consultation with a healthcare professional based on the individual's specific medical needs and treatment goals.

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Who is a good candidate for Xolair?

Determining whether someone is a suitable candidate for Xolair involves assessing various factors related to their medical history, symptoms, and treatment goals. Generally, individuals who may benefit from Xolair therapy include:

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Patients with Allergic Asthma: Individuals with moderate to severe persistent allergic asthma who have not achieved adequate symptom control with inhaled corticosteroids or other standard asthma medications.

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Patients with Chronic Idiopathic Urticaria (CIU): Those experiencing chronic hives of unknown cause that are not well-managed with antihistamines or other conventional therapies.

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Frequent Asthma Exacerbations: Individuals who experience frequent asthma exacerbations despite adherence to their current asthma treatment regimen.

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High Levels of Immunoglobulin E (IgE): Patients with elevated levels of IgE, as Xolair works by targeting and inhibiting IgE, a key player in the allergic response.

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Persistent Symptoms: Those whose symptoms significantly impact their quality of life and daily functioning despite adherence to standard treatment protocols.

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Ultimately, the decision to initiate Xolair therapy should be made by a healthcare professional after a comprehensive evaluation of the individual's medical history, allergy symptoms, and treatment needs. Regular monitoring and follow-up appointments are essential to assess treatment effectiveness and adjust the treatment plan as necessary.

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What is the success rate for Xolair? 

The success rate of Xolair treatment can vary depending on factors such as the specific allergic condition being treated, the severity of symptoms, and individual response to the medication. Clinical studies have demonstrated that Xolair can significantly reduce asthma exacerbations, improve lung function, and enhance quality of life in patients with allergic asthma. Similarly, Xolair has been shown to effectively reduce the frequency and severity of hives in patients with chronic idiopathic urticaria. In the recent clinical trials for Xolair treating food allergies, 68% of participants were able to eat the single dose of peanut protein without moderate to severe allergic symptoms. However, it is essential to discuss treatment expectations and potential outcomes with your healthcare provider to determine if Xolair is the right choice for you.

Frequently Asked Questions

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What if I miss a dose?

If you give yourself this medication at home: If you miss a dose, take it as soon as you can. Then continue your normal schedule. If it is almost time for your next dose, take only that dose. Do not take double or extra doses. Call your healthcare provider with questions.

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Is Xolair FDA Approved?

Yes, Xolair is FDA approved for the treatment of allergic asthma, chronic idiopathic urticaria, and most recently approved for the treatment of food allergies in certain patient populations. It was first approved by the FDA in 2003 for the treatment of moderate to severe persistent allergic asthma in patients 6 years of age and older who have a positive skin test or in vitro reactivity to a perennial aeroallergen and whose symptoms are inadequately controlled with inhaled corticosteroids. In 2024, the FDA approved Xolair for IgE-mediated food allergies (Type 1). 

Is Xolair covered by insurance?

Coverage for Xolair may vary depending on factors such as insurance provider, specific insurance plan, and the indication for which it is prescribed. Many insurance plans offer coverage for Xolair when prescribed for FDA-approved indications such as allergic asthma and chronic idiopathic urticaria. Patients are encouraged to check with their insurance provider to determine coverage eligibility and any potential out-of-pocket costs.

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Xolair emerges as a groundbreaking solution in the realm of food allergies, offering hope and tangible relief to individuals navigating the complexities of allergic reactions. At Aspire Allergy & Sinus, we're proud to announce that we now provide Xolair as part of our comprehensive food allergy treatment options. If you or a loved one seeks effective management of food allergies, we invite you to take the next step towards a safer, more confident future by booking a consultation with us today. Together, let's embark on a journey towards a life liberated from the constraints of food allergies.