A drug long utilized to combat allergic asthma and hives has shown remarkable efficacy in diminishing the risk of life-threatening reactions in children with severe food allergies when exposed to minute traces of peanuts, cashews, milk, and eggs, according to researchers.
The drug, known as Xolair, which has already secured approval from the Food and Drug Administration (FDA) for adults and children over the age of one with food allergies, represents a groundbreaking advancement in allergy management. It stands as the inaugural treatment capable of substantially slashing the likelihood of severe reactions, including anaphylaxis — a severe allergic reaction inducing shock — triggered by inadvertent exposure to diverse food allergens.
Presented at the annual conference of the American Academy of Allergy, Asthma, and Immunology in Washington, the findings from the study on children and adolescents were published in The New England Journal of Medicine. Dr. Robert A. Wood, the lead author and director of the Eudowood Division of Pediatric Allergy, Immunology, and Rheumatology at Johns Hopkins Children’s Center, lauded the medication’s potential impact, describing it as potentially “life-changing” for a specific subset of food allergy patients.
Dr. Wood elucidated the profound limitations imposed by severe food allergies, highlighting the restrictive dietary constraints endured by individuals afflicted with conditions such as severe milk or egg allergies. These individuals often find themselves unable to dine at restaurants or undertake routine activities, burdened by constant fear and anxiety associated with potential allergen exposures.
The prevalence of food allergies has witnessed a steady ascent over the past two decades, with approximately 5.5 million children and 13.6 million adults in the United States grappling with these conditions. Alarmingly, nearly half of individuals with food allergies have encountered severe, life-threatening reactions, culminating in an estimated 30,000 annual emergency department visits.
The study, considered the gold standard in medical research, employed a rigorous double-blind, randomized, placebo-controlled clinical trial methodology. Conducted across ten medical centers in the United States, the study enrolled 177 children and adolescents aged 1 to 17, all exhibiting allergies to peanuts and at least two other foods, including cashews, milk, eggs, walnuts, wheat, and hazelnuts.
Participants were randomly assigned to receive either Xolair injections or placebo injections every two to four weeks for a duration of 16 to 20 weeks. Upon completion of the treatment phase, participants underwent testing to evaluate their tolerance to trace amounts of food allergens.
Results indicated a notable enhancement in tolerance levels among participants administered Xolair, with 67% of recipients demonstrating the ability to tolerate up to 600 milligrams of peanut protein — equivalent to just over half a teaspoon of peanut butter or about two and a half peanuts — without experiencing serious symptoms. In contrast, only 7% of participants in the placebo group achieved similar tolerance levels.
The efficacy of Xolair varied across different food allergens, with significant improvements observed among those allergic to cashews, milk, and eggs. Notably, more than two-thirds of participants with egg allergies demonstrated tolerance to up to 1,000 milligrams of egg protein following treatment with Xolair, compared to none in the placebo group.
Xolair operates by targeting immunoglobulin E (IgE), a key driver of allergic reactions, effectively mitigating the risk of severe responses to allergen exposure. Despite the drug’s transformative potential, experts caution that it is not a panacea and necessitates continued vigilance in allergen avoidance practices.
While Xolair represents a significant stride in allergy management, experts underscore the imperative of ongoing research to refine treatment modalities and enhance outcomes for individuals grappling with severe food allergies.
