Abstract

The landscape of food allergy (FA) treatment is poised for a paradigm shift with the emergence of biologic therapies. The FDA approval of a standardized peanut Powder for oral immunotherapy (OIT) in 2020 marked a milestone, signaling a departure from allergen avoidance toward proactive treatment strategies. While OIT has been proven effective in desensitizing patients to specific allergens, there are several limitations such as lacking standardization, a long-time commitment to achieve maintenance, and adverse events. Biologics, including omalizumab, dupilumab, and anti-alarmins, have shown promise in treating various allergic diseases, including FA. These biologics target the underlying immunological pathways driving allergic reactions, offering an antigen-agnostic approach. Omalizumab (anti-IgE) has been the most studied biologic in this space and can be utilized both as an adjunct therapy with OIT or as monotherapy. Dupilumab targeting IL-4 and IL-13 also shows promise as an adjunct therapy. The emergence of anti-alarmins further broadens the spectrum of FA treatment possibilities. Biologics represent a transformative approach to FA treatment, directly addressing the underlying mechanisms. Future research should focus on patient selection criteria, personalized biomarker panels, optimal timing of intervention, and treatment durations.

View details for DOI 10.1016/j.jaip.2023.11.032

View details for PubMedID 38013157