Combining anti‐IgE with oral immunotherapy

Food allergy is a significant medical problem that affects up to 8% of children in developed countries. At present, there are no curative therapies available in routine practice and management of food allergy involves strict allergen avoidance, education, and prompt treatment upon accidental exposur...

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Bibliographic Details
Published in:Pediatric allergy and immunology 2017-11, Vol.28 (7), p.619-627
Main Authors: Lin, Chunrong, Lee, Ivan T., Sampath, Vanitha, Dinakar, Chitra, DeKruyff, Rosemarie H., Schneider, Lynda C., Nadeau, Kari Christine
Format: Article
Language:English
Subjects:
Administration, Oral
Adolescent
Allergens
anaphylaxis
Anti-Allergic Agents - therapeutic use
Antibodies, Anti-Idiotypic - immunology
anti‐IgE
Child
Children
Clinical trials
Desensitization
Desensitization, Immunologic - methods
Developed countries
Drug Therapy, Combination
efficacy
Food allergies
food allergy
Food Hypersensitivity - drug therapy
Food Hypersensitivity - immunology
Humans
Immune Tolerance
Immunoglobulin E
Immunological tolerance
Immunotherapy
Immunotherapy - adverse effects
Immunotherapy - methods
Monoclonal antibodies
omalizumab
Omalizumab - therapeutic use
oral immunotherapy
safety
tolerance
Young Adult
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Summary:Food allergy is a significant medical problem that affects up to 8% of children in developed countries. At present, there are no curative therapies available in routine practice and management of food allergy involves strict allergen avoidance, education, and prompt treatment upon accidental exposure. Oral immunotherapy (OIT) is an efficacious experimental approach to food allergy and has been shown to provide a substantial benefit in terms of allergen desensitization. However, OIT is associated with high rates of allergic reactions, and the period of protection offered by OIT appears to be limited and highly variable. Recurrence of allergen sensitivity after a period of treatment discontinuation is commonly observed. With the aim of overcoming these limitations of OIT, several trials have studied omalizumab (anti‐IgE monoclonal antibody) as an adjuvant treatment for patients undergoing OIT. Results from these trials have shown that the addition of omalizumab to OIT leads to a significant decrease in the frequency and severity of reactions, which allows for an increase in the threshold of tolerance to food allergens. This review provides a summary of the current literature and addresses some of the key questions that remain regarding the use of omalizumab in conjunction with OIT.
ISSN:0905-6157
1399-3038
DOI:10.1111/pai.12767