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A new treatment called omalizumab has shown promise in helping children with food allergies become more tolerant to common allergens like peanuts, tree nuts, egg, milk, and wheat. This treatment works by binding to antibodies in the blood that trigger allergic reactions, preventing them from causing harm. A study found that nearly 67% of participants who received omalizumab could consume peanuts without a severe reaction, compared to less than 7% of those who received a placebo. This treatment could offer protection to children from accidental exposures to foods they are allergic to. The Food and Drug Administration has approved omalizumab for reducing allergic reactions in people with food allergies. This new treatment could greatly improve the quality of life for the millions of children in the United States who suffer from food allergies.
Here is a welcome update from an earlier HealthBeat story on the life-threatening dangers children diagnosed with food allergies face when exposed to trace amounts of common allergens. https://baltimoretimes-online.com/featured/2024/01/11/popular-spice-triggers-life-threatening-allergy-attack-of-baltimore-times-publishers-grandson-i-have-lost-faith-in-our-food-safety-laws/
In a groundbreaking clinical trial, a 16-week course of the monoclonal antibody, omalizumab has shown significant promise in increasing the tolerance of children, as young as one years old, to common food allergens such as peanuts, tree nuts, egg, milk and wheat.
Before this breakthrough, oral immunotherapy (OIT), which involves the daily ingestion of increasing doses of a specific food allergen, was the only available treatment for food allergies. Omalizumab operates differently, binding to the immunoglobulin E antibody in the blood that triggers allergic reactions and prevents it from activating key immune cells.
Monoclonal antibodies are like highly specialized soldiers in the immune system’s army, created in a lab to target specific invaders, such as viruses or allergens. Imagine your immune system as a team of defenders in your body, fighting off harmful invaders like bacteria and viruses. Monoclonal antibodies are like reinforcements designed to target and attack one specific type of enemy.
They’re made by copying a single type of immune cell, hence the “mono” (meaning one) in their name. These lab-made antibodies can latch onto the invaders or diseased cells, marking them for destruction or blocking their harmful effects, helping to protect or treat your body against diseases.
Presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting in Washington, D.C., and published in The New England Journal of Medicine, the study reveals that nearly 67% of participants who underwent antibody treatment could consume 600 milligrams (mg) or more of peanut protein—equivalent to 2.5 peanuts—without experiencing a moderate or severe allergic reaction.
This is a stark contrast to the less than 7% of participants who received a placebo and achieved similar results. The treatment also proved effective for other common allergens, including egg, milk, wheat, cashew, walnut, and hazelnut, with participants able to ingest 1,000 mg or more of these proteins.
This indicates that omalizumab could potentially offer protection to children and adolescents from accidental exposures to foods they are allergic to, despite diligent avoidance efforts.
Jeanne Marrazzo, M.D., M.P.H., director of the National Institute of Allergy and Infectious Diseases (NIAID) and the trial’s regulatory sponsor, highlighted the constant vigilance required by individuals with food allergies and their caregivers to prevent life-threatening allergic reactions.
The study’s findings suggest that, alongside food avoidance, omalizumab can help reduce the risk of such allergic reactions, offering a layer of protection from accidental exposure emergencies.
The trial, supported by NIAID with additional backing from Genentech, a Roche Group member, and Novartis Pharmaceuticals Corporation, comes as a beacon of hope for the estimated 7.6% of children in the United States—around 5.5 million—who suffer from food allergies.
On February 16, 2024, the Food and Drug Administration approved omalizumab for reducing allergic reactions, including anaphylaxis, that may occur with accidental exposure to food allergens in adults and children aged one year and older with food allergies.
It is important to note that individuals taking omalizumab should continue to avoid foods they are allergic to, as the treatment is not approved for the emergency treatment of allergic reactions.
Conducted by the NIAID-funded Consortium for Food Allergy Research (CoFAR) across ten U.S. locations, the Omalizumab as Monotherapy and as Adjunct Therapy to Multi-Allergen OIT in Food Allergic Children and Adults (OUtMATCH) trial enrolled 177 children and adolescents aged 1 to 17, and three adults aged 18 to 55, all with confirmed allergies to peanut and at least two other common foods.
The trial’s first stage aimed to determine if omalizumab could increase the threshold of food causing allergic reactions, thereby reducing the likelihood of reactions from accidental exposure. The results were promising, showing omalizumab’s superiority over placebo in raising the reaction threshold for peanuts, milk, egg, cashew, wheat, walnut, and hazelnut to levels that could protect against accidental allergic reactions.
Many participants treated with omalizumab were able to consume significantly more than the threshold amounts of peanut protein without a moderate or severe allergic reaction, with some consuming amounts equivalent to about 25 peanuts.
This tolerance extended to multiple foods, suggesting that omalizumab could dramatically improve the quality of life for individuals with food allergies by reducing the risk associated with accidental exposure.