N Engl J Med

AAAAI Conference: Omalizumab boosts tolerance to multiple food allergies, according to study

March 5, 2024

In this study, researchers assessed whether omalizumab, a monoclonal anti-IgE antibody, would be safe and effective as monotherapy in patients with multiple food allergies. Their findings, which were presented at last month’s American Academy of Allergy, Asthma, & Immunology Annual Meeting (AAAAI) in Washington, D.C., suggest that omalizumab treatment for 16 weeks was superior to placebo in increasing the reaction threshold for peanut and other common food allergens in people as young as one year of age.

• 462 people aged one to 55, who were allergic to peanuts and at least two other trial-specified foods (cashew, milk, egg, walnut, wheat, and hazelnut), were screened for inclusion.
• Participants were randomly assigned, in a 2:1 ratio, to receive omalizumab or placebo administered subcutaneously (with the dose based on weight and IgE levels) every 2 to 4 weeks for 16 to 20 weeks, after which the challenges were repeated.
• Primary end point was ingestion of peanut protein without dose-limiting symptoms; the three key secondary end points were the consumption of cashew, milk, and egg, also without dose-limiting symptoms.
• The analysis population consisted of 177 children and adolescents.
• A total of 79 of the 118 participants (67%) receiving omalizumab met the primary end-point criteria, as compared with 4 of the 59 participants (7%) receiving placebo (P<0.001).
• Results for the key secondary end points were consistent with those of the primary end point (cashew, 41% vs. 3%; milk, 66% vs. 10%; egg, 68% vs. 0%; P<0.001 for all comparisons).
• Safety end points did not differ between the groups, aside from more injection-site reactions in the omalizumab group.

Source:

Wood RA, et al. (2024, February 25). N Engl J Med. Omalizumab for the Treatment of Multiple Food Allergies. https://pubmed.ncbi.nlm.nih.gov/38407394/