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by modeless 850 days ago
I've been following this closely. I'm most interested in Xolair (and another one, Dupixent) as a way to make oral immunotherapy (OIT) safer and more effective. Xolair can reduce reactions for sure, but it can't get people to the point where they can actually eat normal serving sizes of their food allergens. Oral immunotherapy can do that. And Xolair is a twice monthly injection. Nobody wants to do that for the rest of their life, and if OIT is successful presumably you could stop Xolair after.

Unfortunately neither Xolair or Dupixent has looked super promising in early study results when combined with OIT. But Dupixent in particular is approved to treat one of the possible side effects of OIT, EoE (inflammation of the esophagus), so I'm still hopeful.

4 comments

I’ve been on Dupixent and have a large number of allergies.

100% helped eczema. I used to have it to the point all my fingers were split in 5-8 places and I’d rate the pain scale at 8-9/10 (10 being arm cut off). I used to get blisters under the skin that’d combine and basically just peal off the skin - https://www.mayoclinic.org/diseases-conditions/dyshidrosis/s...

Anyway, Dupixent made it entirely go away. I also found my allergies did improve (suddenly wasn’t allergic to dogs). That said, it did have a side effect of severely drying out my eyes and I’ll get weird rashes on my face periodically and it requires injections 2x per month. That said, I can use my hands now, frankly I can think too. Pain is gone, and idc about the symptoms.

I had the exact same experience.

I'm on Dupixent indefinitely for eczema, which it cures 100%. As a side effect, it 100% cured my seasonal hay fever and reduced many of my food allergies to a level, where I can just eat the food and ignore the very slight allergic reaction that remains.

For me, the entire field of monoclonal antibody therapy is pure magic. Absolutely amazing how well it works, a true silver bullet (with home injections twice a month and eye drops for the dry eyes).

I get dyshidrotic eczema on my hands, have for decades, and had no idea dupixent could help that. It doesn’t cause me pain though; the blisters and peeling skin are certainly annoying, but the side effects sound like the same level of annoying.
UV light therapy may be an option for that. It's even possible to self-administer with a 365nm UV flashlight, which I have done successfully. I'll stop short of recommending anyone else actually do that themselves, but I will definitely do it again if my symptoms return.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497185/

I've been taking Xolair for the last ~4 years for general allergies (with stellar results) and at least for my regimen, it's only once a month, not twice.

My partner was on Dupixent for a while to shrink some nasal polyps—that one is twice a month.

Interesting. I looked at a dosage chart and it seems like you do either once or twice a month based on your IgE level determined by a blood test. So it is twice a month for some people.
Ah, I do get two shots a month because my IgE was wicked high, but I get them both at the same time. One in each arm!
My wife also gets 2 a month, on the same day, but I get to stab her in the gut. Good times!
I'm not sure of the current progress, but I was at a conference a couple years ago, and the Dupixent folks were presenting. It was right after the approval for pediatric atopic derm, and they were hopeful that for people with severe allergies, they could essentially use dupixent to wipe out the immune sensitivity to allergens and then retrain. This is pretty extreme, so you'd only want to do it in patients with life-threatening allergies, but it was an interesting plan.
I get hay fever every Spring so I hope this field gets FDA approval, would be nice to not have to deal with a stuffy nose for an entire season.