What is Xolair (Omalizumab)?

Xolair (Omalizumab) is a monoclonal antibody medication used to manage food allergies, severe allergic asthma and chronic hives (urticaria). It works by targeting and inhibiting the activity of Immunoglobulin E (IgE), an antibody that plays a central role in allergic reactions. By blocking IgE, Xolair reduces the release of histamine and other chemicals that trigger allergic symptoms like hives, sneezing, swelling, and difficulty breathing.

For children with food allergies, Xolair can be an effective option, especially for those with multiple food allergies, severe reactions to foods, and those with more than one allergic condition (such as food allergies, asthma, seasonal allergies, allergic eczema, or hives). 

Here’s what Xolair does:

• Reduces the immune system’s sensitivity to allergens
• Helps reduce the frequency and severity of allergic reactions to food
• Improves asthma control, reducing wheezing and other asthma symptoms
• Decreases flare-ups of chronic hives
• Controls seasonal allergies and congestion in adults with allergic rhinitis and nasal polyps.

How Does Xolair Work?

Xolair works by removing IgE from the body. It enters the bloodstream and within the first 24 hours 99% of the IgE is bound to Xolair, which is then eliminated from the body. IgE is also bound to allergy “mast” cells in the skin, mouth, nose, eyes, lungs, stomach, and blood vessels. As IgE disconnects from the allergy mast cells, Xolair quickly binds the IgE and removes it from the body. Over time, the allergy cells become less reactive. See the official Xolair website for more information (How XOLAIR® (omalizumab) May Work to Treat Food Allergy).

[This is Chat GPT’s version of the above. I’m not sure which sounds better to a layperson: Xolair targets and removes IgE, a key protein involved in allergic reactions. Once in the bloodstream, Xolair binds to 99% of free IgE within 24 hours, preventing it from triggering allergic responses. IgE also detaches from allergy “mast” cells in the skin, nose, lungs, and other tissues, allowing Xolair to bind and eliminate it. Over time, this process makes allergy cells less reactive, reducing allergic symptoms.]

1. Binds to IgE in the blood:
   IgE antibodies are responsible for triggering allergic reactions in the body. By binding and eliminating IgE, Xolair prevents the immune system from overreacting to allergens, making it a beneficial treatment for food allergies, asthma, and chronic hives.
2. Reduces Inflammation:
   Xolair helps to reduce the inflammation caused by allergic reactions, particularly in the airways, skin, and gastrointestinal tract. For children with food allergies, this makes allergic reactions to food less frequent and less severe. Reducing inflammation in the airways makes breathing easier for children who suffer from severe asthma related to environmental allergies or allergic reactions to food.
3. Decreases Symptoms of Chronic Hives:
   Xolair also effectively reduces the number and severity of flare-ups in children suffering from chronic hives that don’t respond to antihistamines or other medications.

What to Expect During Treatment with Xolair

Treatment with Xolair is administered through subcutaneous (under-the-skin) injections. Here's what you can expect:

1. Initial Consultation and Testing:
   Your allergist will conduct an in-depth assessment, which may include allergy testing and reviewing your child’s medical history to determine if Xolair is the right treatment option for them.
2. Injections:
   Xolair is injected into the fat under the skin of the upper arm or thigh. , The first 3 doses are given in the doctor’s office to ensure that they are tolerated and to teach you how to administer the injections at home, if you feel comfortable doing so. Each injection is ½ to 2 milliliters and takes less than 30 seconds to administer. The number of injections and the frequency of dosing will depend on your child’s weight, total IgE level in the blood, and the specific allergic condition being treated.
3. Ongoing Monitoring:
   After each injection, your child will be monitored for 30 minutes to 2 hours to ensure there are no immediate allergic reactions. Regular follow-up visits will be scheduled to evaluate progress and adjust treatment as necessary.

Benefits of Xolair (Omalizumab)

Xolair offers significant benefits, especially for children with severe food allergies, asthma, or chronic hives. Some of the key advantages include:

• Reduced risk of food allergy reactions:
  For children and adults with severe or multiple food allergies, Xolair increases the amount of food necessary to cause an allergic reaction. For instance, most children who react to < ⅓ of a peanut before treatment can tolerate 4 peanuts or more without a reaction when treated with Xolair. ‍
• Improved Asthma Control:
  For children and adults with severe allergic asthma, Xolair can reduce asthma attacks and improve breathing by minimizing inflammation in the airways.‍
• Reduction in Hives:
  Children and adults suffering from chronic hives that do not respond to other treatments can experience significant relief, with fewer flare-ups and less discomfort.‍
• Minimal Side Effects:
  Since Xolair specifically targets IgE, which is primarily involved in the allergic immune response, it generally has few side effects, making it a good choice for children and adults who have not responded well to other treatments.‍
• Long-Lasting Relief:
  Xolair provides long-term relief, with many children reporting improvements in symptoms after just a few doses, continuing over months of treatment.

Who Is a Good Candidate for Xolair?

Xolair is ideal for children with:

• Multiple Food Allergies:
  Children and adults with multiple or severe food allergies (like nut, seed, seafood, milk, egg, wheat, or soy allergies) may benefit from Xolair to help reduce allergic reactions by calming the immune system’s response to food allergens.
• Reactive to trace amounts of food:
  Children and adults who react to trace amounts of food are at risk of severe reactions to accidental ingestions of these foods. Xolair reduces this risk. While such people may benefit from desensitization to the food through oral immunotherapy (OIT), they may not tolerate even the smallest doses of the OIT treatment. Xolair-assisted OIT may be an option for certain people. ‍
• Severe Allergic Asthma:
  If your or your child’s asthma is poorly controlled by inhalers or oral medications, Xolair may offer better asthma management and improve their overall quality of life.‍
• Chronic Urticaria (Hives):
  For children and adults with chronic hives that don’t respond to antihistamines or other treatments, Xolair can help reduce symptoms and prevent flare-ups.‍
• Nasal polyps and seasonal allergies:
  For adults with nasal polyps and chronic allergic rhinitis, Xolair can reduce congestion and prevent nasal polyps from progressing or returning after surgery. 

If you or your child struggles with food allergies, asthma, hives, or seasonal allergies and other treatments have not provided relief, Xolair may be the solution for them. Contact us to see if Xolair is the right treatment for your child.

Potential Side Effects and Considerations

While Xolair is generally safe for most children, there are potential side effects to be aware of:

1. Injection Site Reactions:
   Some children may experience redness, swelling, or pain at the injection site. These reactions are typically mild and subside on their own.
2. Allergic Reactions:
   While rare, some people may have an allergic reaction to Xolair. For this reason, the first 3 injections are administered in a medical setting with close monitoring for any adverse reactions.
3. Muscle aches, Swollen joints, and Rash:
   Muscle aches, swollen joints, and rash can be signs of a very rare type of allergic reaction to injected medications called serum sickness.
4. Risk of Parasite Infections:
   Xolair reduces IgE, which may increase the risk of parasite infections. Extra caution should be taken to reduce the risk of parasite exposure such as when camping or visiting a country where parasite infections are common.
5. Cancer and Circulation problems:
   While not uncommon in the general population, adults treated with Xolair have experienced cancer, chest pain, heart attack, blood clots in the lungs or legs, or temporary symptoms such as weakness on one side of the body, slurred speech, or changes in vision more frequently than similar patients who did not receive Xolair in some studies. It is not known whether Xolair contributed to these conditions.

Is Xolair Right for Your Child?

Xolair can be an effective treatment for children with severe food allergies, asthma, and chronic hives. If your child has not found relief through traditional treatments, Xolair may be the next step in managing their symptoms.

To learn more about how Xolair can help manage your child’s allergies and asthma, schedule a consultation with one of our experts at Empower Allergy Treatment.

Conclusion

Xolair (Omalizumab) is a revolutionary treatment that can help children with severe food allergies, asthma, and chronic hives. By targeting the root cause of allergic reactions, Xolair provides lasting relief and improves your child’s quality of life.

If you’re interested in learning more about Xolair and how it can help your child manage their allergies, contact Empower Allergy Treatment today to schedule a consultation.

Contact Us Today to find out how Xolair can help your child live a safer, more comfortable life.