My wife and I both have seasonal allergies. My allergies are mild, primarily during the spring. On the other hand, Allergy Season for my wife lasts 12 months a year. She is especially allergic to Texas mountain cedar. As the juniper releases pollen November through February. So-called Texas Cedar Fever affects one-in-five Texans. My wife has seen allergy specialists, who tested her for dozens of allergens. Allergy shots did not work well for her. My mother also took allergy shots but later abandoned the therapy as ineffective.
First generation of antihistamines were discovered nearly 100 years ago. They mask allergy symptoms but are sedating and must be taken every day – sometimes multiple times. Second generation nonsedating antihistamines do not seem to work as well but won’t put you to sleep. There are also steroid aerosol inhalers. I’ve tried them but am not convinced they make much difference. In surveys patients tend to rate allergy medications low on effectiveness. But what if there was a way to stop histamine before it starts?
Medical researchers are finding that monoclonal antibodies from a biological drug Xolair (omalizumab) are really good at allergy relief. By good I mean one shot is good for months. It stops allergies at their source, before histamine is released. The following is how Vox explains it:
When pollen and other allergens emerge every year and enter your body through your eyes, ears, or nose while you’re enjoying the crisp spring air, your body’s immune system overreacts. Immunoglobulin, proteins that are supposed to identify and attack parasites or a virus, instead go after the otherwise harmless allergen.
When the immunoglobulin attacks the allergen, your body releases histamine, a chemical critical to inflammation (which, again, is really important when you are actually exposed to a dangerous parasite or virus). That inflammation then creates all that mucus and sneezing.
Monoclonal antibodies stop that process before it begins. They deliver artificial proteins that carry instructions to your immune system to block the receptors that create allergic reactions and prevent the overresponse that releases histamine in the first place.
Xolair works far better at blocking histamines than prescription or over-the-counter antihistamines. Imagine one shot and your allergies are gone for months. More about Omalizumab from Wikipedia:
Omalizumab is a glycosylated IgG1 monoclonal antibody produced by cells of an adapted Chinese hamster ovary (CHO) cell line.
OK, maybe you don’t want to know more about how Omalizumab is made. As you can see, it is not like mixing up a batch of chemical powders that are pressed into pills. More from Vox:
Omalizumab, sold as Xolair, is an asthma medication that was approved more than 20 years ago, but it has proven successful in treating seasonal allergies in recent preliminary trials. So successful, in fact, that now some doctors in the US are prescribing it for certain patients during hay fever season. It is an injection, rather than a pill or a spray, that’s given a couple of weeks before pollen and grass levels start to rise.
One obvious benefit is you get a single shot and enjoy your spring. But even better, omalizumab can forestall allergic reactions at the source. That means an injection could stop all allergic reactions — not only seasonal allergies but food allergies (such as peanuts) and insect allergies for a prolonged period of time. This class of treatment — monoclonal antibodies, special artificial proteins that carry instructions to the body’s immune system — have the potential to be a genuine all-in-one allergy wonder drug.
The only downside? Xolair is expensive. Your insurance is unlikely to cover it. An annual shot could set you back nearly $2,000 when accounting for physician visits. Furthermore, Omalizumab, an asthma drug, is not yet approved for allergies and must be prescribed off-label. Your primary care physicians will probably not agree to prescribe it. An allergy specialist might but may want to exhaust the old methods first.
The FDA recently approved a generic omalizumab, but I cannot find any information about its cost. An Israeli pharmacy will ship Xolair to your door for $935, but you need a valid prescription, and it must be refrigerated during its journey. Then there is India. The country makes all manner of pharmaceuticals, sometimes with questionable manufacturing practices. Generic omalizumab made in India is as low as $100, excluding a plane ticket.
Despite the current obstacles, perhaps within a few years a visit to the doctor will result in long-lasting relief from seasonal allergies.
Read more at Vox Media: Is there a cure for seasonal allergies? Actually, yes.