Omalizumab Helped Ease Multiple Food Allergies at Once

Omalizumab treatment helped patients tolerate up to five food allergens simultaneously

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Treatment options for food allergies are limited, especially for people with more than one food allergy. Recent research has uncovered a medication that may help people control multiple food allergies.

A recent study tested whether people with multiple food allergies would benefit from receiving omalizumab (brand name Xolair) before being gradually exposed to their food allergens. This gradual exposure is used to desensitize people to their allergies.

This study showed that after pre-treatment with omalizumab, people with multiple food allergies were able to ingest up to five different allergens simultaneously without having an allergic reaction.

The researchers found that these people became desensitized to allergens almost five times quicker than those in a similar previous study who did not receive pre-treatment.

"Tell your doctor if you have food allergies."

The lead author of this study was Kari C. Nadeau, MD, PhD, from the Allergy, Immunology and Rheumatology Division at Stanford University in Stanford, California.

The study included 22 people who were allergic to at least two allergens out of cow's milk, egg, peanut, nuts, grains and sesame seeds.

The participants were between the ages of 4 and 16 years old, and 76 percent of the participants were male.

These children were pre-treated with omalizumab for eight weeks after enrollment.

Nine weeks after the first injection, these participants were given increasing dosages of up to five allergens over a period of 2.5 hours.

The participants then spent eight more weeks on omalizumab and steadily increased the dosage of food allergens through an at-home program.

After week 16, the participants stopped taking omalizumab but continued to increase the dose of each allergen until each participant was able to tolerate a maintenance dose of 4 grams — up to 20 grams total — of each allergen without having an allergic reaction.

There were 227 total doses given during pre-treatment, and then 7,530 total doses given throughout the eight-week home program.

The findings showed that 401 (5 percent) out of the 7,530 doses triggered an allergic reaction at a median rate of three per 100 doses.

Most home reactions happened during the first months of the program, but by six months after omalizumab therapy, the reactions had dropped by 70 percent from 11 reactions per 100 doses to three reactions per 100 doses.

The researchers found that no serious adverse reactions (i.e., death or hospitalization) happened during the study.

One participant had a severe allergic reaction upon reaching maintenance dose, and he was able to resolve the reaction with a self-injection of medication after five minutes.

All participants were able to reach their maintenance dose by nine months, with a median period of 18 weeks.

In an earlier study in which participants did not receive the pre-treatment of omalizumab, the median period until maintenance dose was reached was 85 weeks. However, the researchers noted that the previous study had a different dose increase schedule.

Dr. Nadeau and team suggested that further research compare omalizumab use to a placebo (fake medication) with the same dosing schedule.

These findings could affect both the wallet and quality of life of food allergy patients.

Because the participants were able to reach their maintenance dose so soon, the cost of treatment is likely to be much less.

In addition, patients with multiple food allergies, compared to those with a single food allergy, are likely to have a lower quality of life, more likely to have a diet deficiency and less like to spontaneously outgrow an allergy.

These researchers mentioned a few limitations to their study. First, the dosage regimen was specific to each participant based on body measurements and tolerance. Second, the study did not include participants with very severe allergies. Third, the method of administering omalizumab was an experimental treatment.

This study was published on February 28 in Allergy, Asthma & Clinical Immunology.

Stanford University's Fund for Food Allergy Research provided funding.

Review Date: 
February 28, 2014
Last Updated:
March 3, 2014