Immunotherapy and Oral Immunotherapy with Omalizumab for Food Allergies
Food allergy is potentially life-threatening and has a major impact on quality of life. Avoidance is currently the only approved therapy, and, although effective, avoidance diets can be difficult and may also put children at risk of nutritional deficiencies and impaired growth. At least 80% of milk...
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2019-12-01
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doaj-cc609241f8b84395a0d9d1d64f6c129b2020-11-25T03:15:24ZengEuropean Medical JournalEuropean Medical Journal2397-67642019-12-01446370Immunotherapy and Oral Immunotherapy with Omalizumab for Food AllergiesShoichiro Taniuchi0Masahiro Enomoto1Hirotaka Minami2Department of Pediatrics, Takatsuki General Hospital, Osaka, JapanDepartment of Pediatrics, Takatsuki General Hospital, Osaka, JapanDepartment of Pediatrics, Takatsuki General Hospital, Osaka, JapanFood allergy is potentially life-threatening and has a major impact on quality of life. Avoidance is currently the only approved therapy, and, although effective, avoidance diets can be difficult and may also put children at risk of nutritional deficiencies and impaired growth. At least 80% of milk and egg-allergic children are expected to achieve natural tolerance to these foods by adulthood, and 15–20% of peanut or tree nut-allergic individuals ‘outgrow’ their allergies. Effective therapies for food allergies are therefore highly desirable. There have been several immunotherapies for food allergy such as oral immunotherapy (OIT), sublingual immunotherapy (SLIT), epicutaneous immunotherapy (EPIT), and OIT combined with anti-IgE monoclonal antibodies (omalizumab [OMB]). However, efficacy and safety have only been demonstrated in one large Phase III trial for peanut allergies. Additionally, there have only been three randomised, controlled studies of OMB–OIT combination and these were low-powered, single-centre trials; therefore, evidence levels were low in these trials. Studies that included long-term follow-up observations and clinical tolerance are rare. Additionally, clinical tolerance is not well-defined and remains unknown. Therefore, several problems remain to be resolved, but hopefully OIT in combination with OMB will resolve these problems in the future. Although there are only three randomised, controlled trials of OMB–OIT, the combination therapy enabled high dose desensitisation for a short duration without any adverse events, resulting in the sustained unresponsiveness in IgE-related food allergy. It is speculated that this combination therapy will be the most effective immunotherapy in the future.https://www.emjreviews.com/allergy-immunology/article/immunotherapy-and-oral-immunotherapy-with-omalizumab-for-food-allergies/desensitisationfood allergyomalizumab (omb)oral immunotherapy (oit) |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shoichiro Taniuchi Masahiro Enomoto Hirotaka Minami |
spellingShingle |
Shoichiro Taniuchi Masahiro Enomoto Hirotaka Minami Immunotherapy and Oral Immunotherapy with Omalizumab for Food Allergies European Medical Journal desensitisation food allergy omalizumab (omb) oral immunotherapy (oit) |
author_facet |
Shoichiro Taniuchi Masahiro Enomoto Hirotaka Minami |
author_sort |
Shoichiro Taniuchi |
title |
Immunotherapy and Oral Immunotherapy with Omalizumab for Food Allergies |
title_short |
Immunotherapy and Oral Immunotherapy with Omalizumab for Food Allergies |
title_full |
Immunotherapy and Oral Immunotherapy with Omalizumab for Food Allergies |
title_fullStr |
Immunotherapy and Oral Immunotherapy with Omalizumab for Food Allergies |
title_full_unstemmed |
Immunotherapy and Oral Immunotherapy with Omalizumab for Food Allergies |
title_sort |
immunotherapy and oral immunotherapy with omalizumab for food allergies |
publisher |
European Medical Journal |
series |
European Medical Journal |
issn |
2397-6764 |
publishDate |
2019-12-01 |
description |
Food allergy is potentially life-threatening and has a major impact on quality of life. Avoidance is currently the only approved therapy, and, although effective, avoidance diets can be difficult and may also put children at risk of nutritional deficiencies and impaired growth. At least 80% of milk and egg-allergic children are expected to achieve natural tolerance to these foods by adulthood, and 15–20% of peanut or tree nut-allergic individuals ‘outgrow’ their allergies. Effective therapies for food allergies are therefore highly desirable. There have been several immunotherapies for food allergy such as oral immunotherapy (OIT), sublingual immunotherapy (SLIT), epicutaneous immunotherapy (EPIT), and OIT combined with anti-IgE monoclonal antibodies (omalizumab [OMB]). However, efficacy and safety have only been demonstrated in one large Phase III trial for peanut allergies. Additionally, there have only been three randomised, controlled studies of OMB–OIT combination and these were low-powered, single-centre trials; therefore, evidence levels were low in these trials. Studies that included long-term follow-up observations and clinical tolerance are rare. Additionally, clinical tolerance is not well-defined and remains unknown. Therefore, several problems remain to be resolved, but hopefully OIT in combination with OMB will resolve these problems in the future. Although there are only three randomised, controlled trials of OMB–OIT, the combination therapy enabled high dose desensitisation for a short duration without any adverse events, resulting in the sustained unresponsiveness in IgE-related food allergy. It is speculated that this combination therapy will be the most effective immunotherapy in the future. |
topic |
desensitisation food allergy omalizumab (omb) oral immunotherapy (oit) |
url |
https://www.emjreviews.com/allergy-immunology/article/immunotherapy-and-oral-immunotherapy-with-omalizumab-for-food-allergies/ |
work_keys_str_mv |
AT shoichirotaniuchi immunotherapyandoralimmunotherapywithomalizumabforfoodallergies AT masahiroenomoto immunotherapyandoralimmunotherapywithomalizumabforfoodallergies AT hirotakaminami immunotherapyandoralimmunotherapywithomalizumabforfoodallergies |
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