title: The Use of Omalizumab in Food Oral Immunotherapy.
abstract: Food allergy is an important health issue that affects up to 8 % of the population. The management of allergic patients involves allergen avoidance and prompts the treatment of accidental reactions, as no curative treatment is available so far in routine practice. Oral immunotherapy (OIT) is a promising therapeutic alternative, but it is associated with frequent allergic reactions and cost-effectiveness issues. In hopes of reducing such reactions, a number of trials have used omalizumab, an anti-IgE monoclonal humanized antibody, as adjunctive therapy in OIT. The allergens studied in these omalizumab-enabled OIT trials include peanuts, milk, eggs, or mixes of multiple foods. In this article, we review the major findings from these studies and discuss potential benefits and issues related to omalizumab-enabled OIT. Results from the previous trials suggest that the use of omalizumab could potentially lead to safer and more efficient OIT protocols, by reducing the number and severity of reactions, and increasing allergen tolerance threshold. While more evidence is needed with regard to the maintenance of the long-term tolerance after OIT, omalizumab's potential immunomodulatory role could be of benefit. More studies are needed to further document this new indication for omalizumab.
authors.affiliation: Pediatric Allergy and Clinical Immunology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.
authors.forename: Roxane
authors.initials: R
authors.lastname: Labrosse
authors.affiliation: Allergy and Clinical Immunology, CHUM, University of Montreal, Montreal, QC, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Graham
authors.affiliation: Pediatric Allergy and Clinical Immunology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Des Roches
authors.affiliation: Pediatric Allergy and Clinical Immunology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada. philippe.begin@umontreal.ca.|Allergy and Clinical Immunology, CHUM, University of Montreal, Montreal, QC, Canada. philippe.begin@umontreal.ca.
authors.forename: Philippe
authors.identifier: http://orcid.org/0000-0002-9089-4604
authors.initials: P
authors.lastname: Bégin
mesh_terms: D000284:Administration, Oral; D000485:Allergens / Q000276:immunology*; D000707:Anaphylaxis / Q000209:etiology / Q000517:prevention & control*; D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D005502:Food; D005512:Food Hypersensitivity / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007108:Immune Tolerance; D007073:Immunoglobulin E / Q000276:immunology / Q000378:metabolism*; D000069444:Omalizumab / Q000627:therapeutic use*
chemical_list: D000485:Allergens; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab; D007073:Immunoglobulin E
keywords: Anti-IgE therapy; Desensitization; Food allergy; Immunotherapy; Omalizumab; Oral immunotherapy