In a significant advancement for food allergy treatment, preliminary results from an ongoing study suggest that many children can successfully consume their trigger foods even after discontinuing the anti-allergy medication Xolair (omalizumab). The findings, presented at the American Academy of Allergy, Asthma & Immunology and World Allergy Organization Joint Congress in San Diego, offer new hope for food allergy management.
Study Findings and Success Rates
The research, conducted across multiple hospitals, tracked 60 children who had previously received Xolair treatment for at least 24 weeks. After stopping the medication, researchers monitored the participants' ability to consume various allergens over a one-year period. The results showed impressive success rates:
- 61-70% of children successfully consumed milk, egg, or wheat
- 38-56% demonstrated tolerance to peanuts or tree nuts
- Success was defined as consuming at least 300mg of the trigger food daily
Treatment Protocol and Implementation
Dr. Jennifer Danzer, pediatric allergist at Johns Hopkins Children's Center, explained that each participant was assigned three treatment plans targeting specific food triggers. Notably, 82% of these plans involved supervised consumption of trigger foods under medical guidance.
"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," stated Dr. Danzer. She emphasized that while Xolair shows promise for expanded applications, potential risks must be carefully considered.
Clinical Implications and Limitations
The study encountered several challenges, including:
- Treatment failures due to taste aversion
- Allergic reactions in some participants
- Two cases of eosinophilic esophagitis leading to treatment discontinuation
Dr. Robert Wood, director of the Eudowood Division of Allergy, Immunology and Rheumatology at Johns Hopkins Children's Center, highlighted that successful desensitization occurred while Xolair remained in patients' systems. However, maintaining tolerance requires strict adherence to daily allergen exposure, potentially indefinitely.
Comparative Treatment Perspectives
Recent research comparing Xolair with oral immunotherapy suggests that Xolair may offer superior outcomes, though both remain viable treatment options. Dr. Sharon Chinthrajah from Stanford Medicine emphasized that treatment selection should be individualized, considering patient-specific goals and circumstances.
Safety Considerations and Medical Oversight
Healthcare providers stress several crucial points:
- The approach should only be implemented under strict medical supervision
- Risk of severe allergic reactions remains
- Xolair itself can cause severe allergic reactions
- Treatment modifications should never be attempted independently
While Xolair received FDA approval in February 2024 for reducing reactions from accidental exposure, its use for intentional allergen consumption remains off-label, requiring careful medical oversight.
