A recent study published in Pediatric Allergy and Immunology suggests that omalizumab, a monoclonal antibody used to treat severe allergic asthma, may also provide benefits for children with comorbid food allergies and elevated serum total IgE levels.
Led by Giulio Dinardo, a student from the department of woman, child and general and specialized surgery at the University of Campania Luigi Vanvitelli, the study observed positive outcomes in children with severe allergic asthma and high serum total IgE levels ranging from 1,500 kU/L to 3,300 kU/L when treated with omalizumab.
The research team reported no severe adverse events associated with omalizumab treatment among the study participants, suggesting its safety profile in this population. Omalizumab, marketed as Xolair by Genentech and Novartis, is typically recommended for asthma patients with IgE levels below 1,500 kU/L due to concerns about adverse reactions in those with higher total IgE levels.
Despite initial concerns about the potential for adverse events, the study found that omalizumab effectively reduced levels of free circulating IgE without causing severe side effects. The treatment led to improvements in asthma control test scores and lung function (FEV1 percentages) in all seven patients studied.
Notably, the use of fluticasone and budesonide maintenance treatments also decreased in some patients following omalizumab therapy, indicating a potential reduction in the reliance on corticosteroids for asthma management.
Throughout the 2-year follow-up period, none of the patients experienced asthma exacerbations or required emergency care. Additionally, there were no reports of severe adverse events or severe injection site reactions, further supporting the safety of omalizumab in this cohort.
Although one patient experienced mild adverse events in the form of a headache and fever following omalizumab administration, these symptoms resolved without discontinuation of treatment.
Importantly, the study also assessed the impact of omalizumab on food allergies in these children. Patients with IgE-mediated food allergies, including cow’s milk, egg, and peanut, saw significant improvements in food desensitization following omalizumab therapy.
Oral food challenges conducted at year 1 and year 2 demonstrated increased thresholds of reactivity to food allergens, with several patients achieving food desensitization by the end of the study period.
The findings suggest that omalizumab may have broader applications beyond allergic asthma, offering potential benefits for children with comorbid food allergies. The study highlights the importance of personalized treatment approaches for pediatric patients with severe asthma and elevated serum total IgE levels, with omalizumab emerging as a promising therapeutic option for this population.
