Omalizumab is a recombinant humanised monoclonal antibody that inhibits the binding of IgE to high affinity receptors (FceRI) on the surface of mast cells and basophils
Omalizumab in food allergy
- study evidence showed that in people aged 1-55 years with multiple food allergies (n=180), omalizumab for 16 weeks was superior to placebo in increasing the proportion who were able to ingest peanut protein in a single dose of ≥600mg (equal to about 2.5 peanuts) without dose-limiting symptoms (67% vs. 7% placebo; P<0.001)
- key secondary endpoints showed that omalizumab was also superior to placebo in increasing the reaction threshold for other allergens, including cashew (41% vs. 3%), milk (66% vs. 10%), egg (68% vs. 0%; P<0.001 for all comparisons)
- study authors concluded that in persons as young as 1 year of age with multiple food allergies, omalizumab treatment for 16 weeks was superior to placebo in increasing the reaction threshold for peanut and other common food allergens
A systematic review and meta-analysis concluded omalizumab was beneficial as a monotherapy and as an adjunct to oral immunotherapy in patients with IgE-mediated food allergy (2).
Note: omalizumab is approved in the US for immunoglobulin E-mediated food allergy in certain adults and children (3). It has not been authorised for food allergy in regions including the European Union, Australia and the UK.
Reference:
- Wood RA et al. Omalizumab for the Treatment of Multiple Food Allergies. New Eng J Med February 25th 2024.
- Zuberbier T et al. Omalizumab in IgE-Mediated Food Allergy: A Systematic Review and Meta-Analysis. Journal of Allergy and Clinical Immunology: In Practice 2023; 11(4): 1134 - 1146
- US Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-help-reduce-allergic-reactions-multiple-foods-after-accidental (accessed 26 July 2024)