ST. PETERSBURG, Fla. — For 33 million Americans, going out to eat, grocery shopping, and even school lunch time can be a source of anxiety.
According to the group Food Allergy and Research Education (FARE), that’s how many people in the U.S. have food allergies.
A study led by Johns Hopkins Medicine found a drug used to treat allergic asthma can offer relief.
It’s called Xolair, and the principal investigator said stage one of a three-stage study found 67% of people who got regular injections were able to tolerate a fairly large amount of peanut, compared to seven percent in a placebo group. More than half could tolerate other foods that caused reactions.
“Going from what we did before, which was primarily just tell patients they had to avoid what they were allergic to and carry their epinephrine in case they had an accidental exposure, to where we are now with this drug, it really is a potentially life changing medicine for many, many patients,” said Dr. Robert Wood, director of the Pediatric Immunology and Rheumatology Division of Johns Hopkins Children’s Center in Baltimore.
Wood said the first stage of the study was specifically designed to bring back to the U.S. Food and Drug Administration to potentially approve Xolair for use to treat food allergies. The FDA did just that in February, making it the first medication to get approval to help reduce allergic reactions to a number of foods after accidental exposure.
Accidental exposure is something Layan Alabsi’s family has worked to prevent for almost her whole life. Her parents said she was diagnosed with a severe dairy allergy when she was a year old.
“It’s been seven years since then. It’s been hard,” said Layan’s father, Humam Alabsi. “It did limit our social interaction. We’re not able to eat in restaurants. It’s hard for us eating, and she’s not enjoying it. It limited us going to parks or other places because of cross contamination.”
Alabsi said Layan has needed to use an EpiPen three times in her life, and two of those happened last year. In one instance, he said she nearly died after trying her little sister’s ice-cream.
“She already stopped breathing. She lost consciousness,” he said. “Thank God, she stayed with us, but I cried a lot that day.”
The other time, just touching an eraser used by a classmate who’d eaten snacks with dairy in them was enough to trigger a reaction and land Layan in the hospital once again.
“It’s hard for me as a mom, especially in the kitchen,” said Layan’s mother, Dania Alhyasat. “It’s like, when I want to eat something dairy, it’s like I will always clean my hand, brush my teeth, wipe the surface with Clorox wipes.”
Twice a month, Layan and her family make the hour and a half to two-hour drive from their home in Wesley Chapel to Johns Hopkins All Children’s Hospital. Her parents said she’s getting oral immunotherapy for her allergies there and recently got her first injection of Xolair.
“This is such a game changer. We were waiting for years for something to happen in this field, something that we can use as a treatment to lessen the severity of the reaction or to prevent food allergy from developing,” said Dr. Panida Sriaroon, medical director for All Children’s Food Allergy Clinic.
While that last part hasn’t happened yet, she said patients are excited about this new option.
According to the FDA, Xolair was originally approved in 2003 to treat allergic asthma. Wood said that’s also when a study involving a similar drug showed promise in treating food allergies. He said his team and others have done smaller studies through the years signaling this medicine could prevent food reactions. Wood said Xolair’s original use is not so different from its new one.
“The way that it works is that when you develop an allergy, your immune system develops something called IGE antibodies, and this drug is specifically called ‘anti-IGE’. So, it literally blocks, it sops up the IGE that’s in your bloodstream so that it can no longer interact with the food if you’ve had, say, an accidental exposure that would normally lead to an allergic reaction,” Wood said.
Sriaroon said injections are given every two-to-four weeks to patients with life-threatening allergies.
“It’s not a cure,” she said. “So, Xolair will only increase the threshold of someone developing a reaction. In other words, they have a less chance of having severe reactions in case of accidental exposure.”
For families like Layan’s, that’s huge.
“I’m not greedy,” said Alabsi. “I’m not hoping that she’ll consume dairy like other kids. I’m just hoping that it would be safe for her to enjoy life like other kids.”
“I see taking my daughter to a birthday party,” said Alhyasat of where she envisions her daughter to be a year from now. “She can celebrate her best friend’s birthday party, eat a cake with her sitting with her friends in the cafeteria, living her normal life as a child.”
That’s something Layan said she looks forward to, as well.
“When me and my best friend went to Urban Air, I can’t even eat anything or, like, eat pizza,” she said. “It’s kind of hard because I really want to be with friends and not be alone.”
Wood said stages two and three of the study are ongoing, and the next step for Xolair is working through the process of insurance approvals.
Sarah Blazonis
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