Omalizumab for Food Allergies

Omalizumab for Food Allergies

The FDA recently approved omalizumab (Xolair) to treat patients with food allergy including children as young as one year.  The approval came from several research trials including one recently published in the New England Journal of Medicine (NEJM) that was conducted at John’s Hopkins.  This particular study looked at allergy to peanut, cashew, egg, milk, walnut, hazelnut and wheat.  In the case of peanut allergy 67% of the test patients were able to consume 600 mg of peanut (equivalent to four peanuts) without adverse symptoms. 

The current recommendation is to only consider this therapy in people with severe (anaphylactic) food allergy.  In addition, the intent is not to enable ongoing ingestion of the food but to protect against anaphylaxis due to accidental exposure.  

An accompanying editorial in the NEJM was a bit of a devil’s advocate pointing out that the treatment is not curative but only works as long as the medication is continued.  It further argued that avoidance is still the lynch pin of therapy in severe food allergy.

The editorial did point out the potential safety net for children who otherwise run the risk of anaphylaxis from accidental exposure. 

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