OIT vs. Xolair - Reducing the Risk of Severe Allergic Reactions

During my visit with my allergist last week, we discussed treatment options to help prevent me from having a dangerous reaction to cashews or pistachios.

If you have severe food allergies you have probably heard about oral immunotherapy (OIT) or Xolair® (omalizumab). These are treatments that are changing the way food allergies are handled. While they both reduce the risks of accidental exposure to allergens, they work differently.

Both OIT and Xolair help lower the risk of a serious reaction caused by accidentally eating a food your allergic to, but neither one is a cure for allergies. The biggest difference is in how they protect us from a severe allergic reaction.

Xolair is a medication you inject that targets IgE (Immunoglobulin E) antibodies that trigger allergic reactions. This helps reduce the risk of a reaction from accidental exposure. According to my allergist and ubiehealth.com, Xolair works a like a sponge for IgE, which plays a key role in allergic reactions. Xolair binds to the free floating IgE in our bloodstream. This reduce the amount of IgE that's available to activate allergy cells like mast cells. Now the immune system is less likely to release a large amount of histamines and other chemicals that cause the symptoms of a severe allergic reaction, like swelling or a sudden drop in your heart rate. Xolair is not used for a specific food, like OIT is. This makes it a great option for people with more than one food allergy. Xolair could also be a good fit if you don’t want to eat a daily dose of the food you're allergic to, but you still want to be protected in case you are ever accidentally eat it. With Xolair, you need weekly or monthly injections. Although it doesn’t cure the allergy, it can reduce the risk of a severe reaction in case you ever have accidental exposure . Because of this, you still need to carry an epi pen.

OIT, or Oral Immune Therapy, is also used to prevent a severe allergic reactions. OIT works by introducing a small amount of whatever food you're allergic to. Over time, it helps the immune system react less to the food Oral Immune Therapy can be a good choice if you have a small number of food allergies, can take a daily dose, or if you want to build tolerance to a food. OIT increases protection in case you're ever exposed to the food, and it means you can actually eat a little bit of of whatever you are allergic to. In addition, OIT has gone through years of clinical testing. However, patients need to take daily doses and go for check up appointments for a long time. In addition, allergic reactions can happen during treatment, and not everyone will be a candidate.

Both treatments can be used together. One of the most exciting areas of allergy research involves combining injectable medicine, like Xolair, with Oral Immune Therapy. Research suggests that Xolair may even help make OIT safer for some patients by reducing the chance of a severe reaction.

So, which treatment is the better one? There isn't a definite answer. OIT and Xolair both work to lower the risk of a severe allergic reaction, but they do it in different ways. The best choice depends on how many foods you're allergic to, how severe your reactions are, and how much time you have to go to doctor’s visits.

For me, Xolair is the better choice, so I recently started taking monthly injections. But no matter which treatment you and your doctor pick, allergy research has come a long way. Now, those of us with allergies have options that can help reduce the severity of our reactions. Xolair has also helped make me a little less fearful and anxious about accidentally eating something with a nut. While there is still no cure for severe food allergies, the scientific progress associated with Xolair suggests we may one day get there.