Although biologics can be effective in reducing allergy symptoms, the high cost of these medications must be weighed when determining whether to use them for allergic rhinitis.

A total of 400 million people around the world are affected by allergic rhinitis. In order to treat the sneezing, runny nose, and itchy eyes that often accompany this condition, individuals may try everything from allergy shots to over-the-counter antihistamines.

But these typical treatments aren’t effective for everyone. A biologic called omalizumab (Xolair) may provide relief from allergic rhinitis when other solutions are ineffective, but it comes with a high price tag.

This article looks at the biologics that have been approved for allergic rhinitis, how they work to relieve symptoms, and when you might consider using them.

What are biologics?

Biologics are a class of drugs made from biological sources. They use proteins, sugars, cells, tissues, and other natural materials from microorganisms, animals, and humans. Biologics frequently mimic cell products that naturally occur in your body.

Unlike synthetic medications, the exact makeup of a biologic may not be fully understood. They also tend to be more heat sensitive and very sensitive to contamination, so extra care may be required during the manufacturing process.

Read more about biologics here.

Was this helpful?

Omalizumab is one biologic that research indicates is effective in the treatment of allergic rhinitis. It has been approved by the Food and Drug Administration (FDA) for moderate to severe persistent allergic asthma, chronic spontaneous urticaria, and chronic rhinosinusitis with nasal polyps.

Other biologics approved for similar or related health conditions include:

Biologics treat allergic rhinitis differently depending on the type of biologic you receive. Omalizumab works by neutralizing the effects of immunoglobulin E (IgE).

Normally, your immune system creates antibodies against harmful germs. But when you have an allergy, your immune system overreacts and treats the allergen like an invading germ.

To fight this germ, the immune system produces antibodies called IgE. These travel through the body to the cells and trigger the release of chemicals that cause the symptoms of an allergic reaction.

Omalizumab binds to allergy antibodies in your blood and the surface of immune cells. This prevents the release of chemicals that cause your runny nose, itchy eyes, and other symptoms associated with an allergic reaction.

When considering who might benefit from biologic therapy, doctors and healthcare professionals must weigh the potential benefits with the high cost. Some of the criteria they may consider are:

  • your resistance to other forms of therapy
  • any other diagnoses you may have
  • how frequently the condition(s) occurs
  • how impaired your quality life is as a result of the condition(s)

When considering biologic therapy for allergic rhinitis specifically, doctors may consider if:

  • You also have a diagnosis of asthma.
  • You have lost your sense of smell.
  • Surgery was previously needed to remove nasal/sinus polyps or for other related complications.

Research indicates that periodic use of biologics may be justified in those with seasonal allergic rhinitis in situations where individuals haven’t been responsive to other treatments, especially if an individual also has asthma.

Biologics are kept in liquid form. They’re delivered via a shot or intravenously (IV).

In 2021, the FDA approved the sale of Xolair (omalizumab) in a prefilled syringe for self-injection. This allows trained people receiving it and caregivers to use this biologic outside of medical offices.

Typical treatment for allergic rhinitis involves a combination of therapies. Doctors may recommend the following treatments to help with symptoms:

The success of these treatments can vary depending on the severity of your allergic rhinitis.

Numerous studies have demonstrated the ability of omalizumab to improve nasal and eye symptoms that come along with allergic rhinitis. But it’s not currently approved by the FDA for this use.

Research is currently lacking about the success of other biologics in relieving allergic rhinitis symptoms. But allergic rhinitis symptoms have been reduced when treating asthma using dupilumab.

Because the cost of biologics is greater than other medications typically used to treat allergic rhinitis, it’s important to weigh the price of biologics against its known success.

When other treatments aren’t offering relief for allergic rhinitis, biologics may be suggested by a doctor. Unlike standard drugs, biologics use natural materials from microorganisms, animals, or humans to offer complex mixtures whose structure may not be fully known.

Research done on a biologic called omalizumab suggests it may be helpful in treating allergic rhinitis in some people, and there are other biologics FDA approved for similar related health conditions.

A doctor can advise you on the options available to you and help you to determine if the potential benefits of a biologic outweigh the costs.