Omalizumab may help treat red meat allergy caused by tick bites

Omalizumab may effectively treat food allergy symptoms in patients with alpha-gal syndrome, according to research from a small study that was to be presented at the American Academy of Asthma, Allergy & Immunology Annual Meeting.

The meeting was canceled because of concerns about COVID-19, the disease caused by the novel coronavirus.

Alpha-gal syndrome is an allergy to red meat and other mammalian products that develops after an individual is bitten by certain ticks. Scott P. Commins, MD, PhD, an associate professor of medicine in the division of rheumatology, allergy and immunology, explained that some patients can remain symptomatic even when adhering to an avoidance diet. He conducted a study to determine whether omalizumab (Xolair, Genentech) could improve symptoms in these patients.

“Xolair is an anti-IgE antibody FDA-approved for moderate to severe persistent asthma and chronic idiopathic urticaria,” Commins told Healio Primary Care. “In our experience, Xolair is well-tolerated by patients with alpha-gal allergy who meet the approved indications.”

Patients with alpha-gal syndrome who were included in the study received 300 mg of omalizumab every 4 weeks. An urticaria activity score that was summed for 7 days was used to assess participants’ itch severity and hive count once daily before taking omalizumab, and again at 4 and 12 weeks after receiving omalizumab therapy.

The study included 14 patients who had a mean urticaria activity score for 7 days of 23.3 (17.8 to 29.4) before receiving treatment.

Commins found the mean score decreased to 4.2 (1.9 to 7.5) by week 4 and to 0.4 (0 to 1.1) by week 12.

In addition, 86% of patients reported an improvement in symptoms after being accidentally exposed to mammalian ingredients, like butter or other dairy products. Some patients reported not experiencing any symptoms after accidental exposure, according to Commins. He added that “several patients noted no symptoms at all despite intentionally eating beef or pork while on [omalizumab].

“Based on these early findings, [omalizumab] may be an effective management and, perhaps, treatment for alpha-gal food allergy,” he told Healio Primary Care.

Commins said that more research is needed to determine if omalizumab is effective in all patients with alpha-gal allergies, and to assess the long-term impact of omalizumab on these and other food allergies. – by Erin Michael

Reference:

Commins, S. Abstract 464. Presented at: American Academy of Asthma, Allergy & Immunology Annual Meeting; March 13-16, 2020 (meeting canceled).

Disclosure: Commins reports receiving research support from the NIH and CDC, serving on the speaker’s bureau for Genentech, and receiving royalties from UptoDate.