Food Allergies: monoclonal antibody promises to reduce reactions

A recent study conducted by researchers at Stanford University in California has revealed promising results in utilizing a monoclonal antibody called omalizumab to combat serious food allergies.    

Omalizumab, originally approved in 2003 for asthma treatment, targets type E immunoglobulins responsible for allergic reactions and has demonstrated significant effectiveness in this new application. The study's findings, published in the New England Journal of Medicine, position omalizumab as a potential first-line therapy, particularly for severe pediatric cases.    

The research team focused on 177 children and teenagers, aged 1 to 17, as well as three adults, all of whom suffered from severe allergies to specific foods. These participants experienced reactions to less than 100 milligrams (mg) of peanut protein (approximately one-third of a peanut) and less than 300 mg of at least two other allergens, including milk, eggs, cashews, walnuts, hazelnuts, and wheat.    

During the study, participants were treated with subcutaneous injections of omalizumab once or twice a month, or with a placebo, over a period of four to five months. Following the treatment, they were closely monitored while consuming the proteins they were allergic to.    

The results demonstrated a significant improvement for those treated with the monoclonal antibody. In the omalizumab group, 67% of participants were able to consume four peanuts without experiencing moderate or severe reactions, compared to only 6.8% of the control group. Furthermore, 44% of treated individuals could eat 25 peanuts without any adverse effects. Similar positive outcomes were observed with other allergenic foods.    

For cashews, 41% of those treated could tolerate one gram without danger, in contrast to only 1% of the control group. The percentages for milk were 66% and 10% respectively, while for eggs, the figures stood at 68% for the treated group and zero for the control group. Notably, almost seven out of ten treated participants could tolerate even small amounts of egg protein, which was previously impossible for them. Moreover, sustained treatment for an additional six months led to all children showing signs of allergy stabilization.    

Compared to current therapies involving long-term oral intake of small doses of allergens, which can be risky and time-consuming, subcutaneous administration of omalizumab offers increased safety and practicality.  

While some questions still remain, such as identifying responders and understanding the duration of treatment necessary, omalizumab holds the potential to transform the lives of millions suffering from severe allergies.    



The New England Journal of Medicine