Abstract

A growing number of studies have shown encouraging results with omalizumab (OMA) as monotherapy and as an adjunct to oral immunotherapy (OMA+OIT) in patients with single/multiple food allergies.To evaluate the efficacy and safety of OMA or OMA+OIT in patients with IgE-mediated food allergy.An extensive literature search (inception-December 31, 2020) was performed to identify randomized, controlled, and observational studies that assessed OMA as monotherapy or OMA+OIT in patients with IgE-mediated food allergy.increase in tolerated dose of foods, successful desensitization, sustained unresponsiveness, immunological biomarkers, severity of allergic reactions to food, quality of life (QoL), and safety. A P < 0.05 was considered significant.In total, 36 studies were included. OMA monotherapy (vs pre-OMA) significantly increased the tolerated dose of multiple foods, increased the threshold of tolerated dose for milk, egg, wheat, and baked milk, improved QoL, and reduced food-induced allergic reactions (all P < 0.01). OMA+OIT significantly increased the tolerated dose of multiple foods (vs placebo and pre-OMA), desensitization (vs placebo+OIT and pre-OMA) (all P = 0.01), and improved QoL (vs pre-OMA) and IgG4 levels (both P < 0.01). No major safety concerns were identified.In IgE-mediated food allergy, OMA can help patients for consumption of multiple foods and allow for food dose escalation. As an adjunct to OIT, OMA can also support high-dose desensitization and higher maintenance doses. Further studies are warranted to empirically evaluate the effect of OMA and confirm these findings.

View details for DOI 10.1016/j.jaip.2022.11.036

View details for PubMedID 36529441