Spring: the season of awakening, of flowers, of life that renews itself. And for millions of people, the season of personal hell. Sneezing in bursts, swollen eyes, runny nose, burning throat. An ordeal that repeats itself every year, faced with an arsenal of sprays, pills and drops that, in the best of cases, make the symptoms bearable. But what if a simple injection could eliminate at the root not only seasonal allergies, but potentially every allergic reaction? Xolair (the trade name for omalizumab) is demonstrating exactly this: a single administration can block allergies before they even manifest themselves, radically changing the approach to a disorder that affects one in three people.
A Revolutionary Approach to Allergies
We may be close to a cure for those pesky spring allergies, and even all allergic reactions. An old asthma drug called omalizumab, sold as Xolair, has been shown in preliminary clinical studies to be able to successfully treat seasonal allergies. Given as a single injection, it is a type of treatment that uses laboratory-made proteins known as monoclonal antibodies that block the body's allergic response at the source. Bottom line: Whether it’s pollen or peanuts that bother you, this medicine can protect you.
“The greatest advantage of antibody-based therapies is that they offer the potential to target the underlying mechanisms that drive allergic reactions in general"
has explained Sayantani Sindher, clinical associate professor at the Sean N. Parker Allergy and Asthma Research Center Stanford University. “This means that antibody-based therapies will simultaneously affect all of the patient’s allergens.”
How Xolair works compared to traditional antihistamines
Antihistamine drugs you are probably familiar with, such as claritin o Zyrtec, target histamine, the chemical your immune system releases when it detects an allergen, triggering those dreaded inflammatory symptoms ranging from runny noses to persistent rashes.
But antihistamines don’t work for everyone and target the symptoms, not the cause. They also require you to keep taking them regularly, which most people don’t do consistently.
Monoclonal antibodies, on the other hand, block histamine from reaching the bloodstream, primarily by targeting an antibody known as immunoglobulin E. Typically, when immunoglobulin E detects an allergen, it binds to the body’s immune cells to instruct them to go into attack mode. Ingeniously, monoclonal antibodies bind to immune cell receptors to block these instructions from reaching them.
Pollen allergies and food allergies are frequently found together. Omalizumab has the potential to treat both.
Efficacy demonstrated in clinical trials
The result is a more effective and long-lasting treatment. Omalizumab requires only a single injection given two weeks before the start of spring. In a randomized study published in the journal Clinical and Translational Allergy, patients who received a 300 mg injection experienced both fewer symptoms and fewer days requiring a daily antihistamine. It controlled nasal symptoms as well as traditional medications and was even better at relieving ocular symptoms.
Overall, the participants' quality of life improved significantly.
The turning point for food allergies
What’s striking is Xolair’s ability to treat food allergies in one go (a use the U.S. Food and Drug Administration approved in early 2024). It may not let you eat everything you want, but it will keep your day from being ruined if you accidentally eat something you’re allergic to.
Xolair, obstacles and future hopes
While traditional allergy shots can help build long-term tolerance to allergens, such treatments take years and only work on one allergen at a time. The benefits of omalizumab are instantaneous, although periodic injections will be needed.
However, with an annual cost that can reach up to $60.000 (about 55.000 euros), Xolair remains prohibitively expensive. But there is a glimmer of hope: the FDA approved a generic version of omalizumab in March, which could reduce costs in the future.
For those who have spent their lives battling debilitating allergies, the prospect of such a simple, effective solution represents a game-changer that could transform spring from a season of suffering to a season of rebirth—as it should be.
