“Promising new treatment” for children with multifood allergies

New research has found a “promising new treatment” protects children with multiple food allergies from reactions to accidentally eating small amounts of allergy-triggering foods.

The findings – outlined in a study in the New England Journal of Medicine – suggest that regular use of the drug omalizumab could protect against severe allergic reactions.

“I’m excited that we have a promising new treatment for multifood allergic patients,” says the study’s senior author Sharon Chinthrajah, associate professor of medicine and of paediatrics at the Stanford University School of Medicine, US. “This new approach showed really great responses for many of the foods that trigger their allergies.”

Lead author Robert Wood, professor of paediatrics at Johns Hopkins University School of Medicine in the US, adds that patients impacted by food allergies face a daily threat of life-threatening reactions due to accidental exposures.

“The study showed that omalizumab can be a layer of protection against small, accidental exposures,” he says.

Food allergies occur when the immune system reacts abnormally to certain foods, producing antibodies that cause an allergic reaction. Food allergies mediated through Immunoglobulin E (IgE) antibodies have symptoms that usually develop within just 60 minutes of ingestion.

Omalizumab is a monoclonal anti-IgE antibody, which means that it binds to and inactivates IgE antibodies. The US Food and Drug Administration originally approved the drug to treat diseases such as allergic asthma and chronic hives.

In this study, 177 children aged 1-17 years old, and severely allergic to peanuts and at least 2 other foods (cashew, milk, egg, walnut, wheat, and hazelnut), were randomly assigned to be administered monthly or bimonthly injections of omalizumab or a placebo.

After 4 months, 67% of participants receiving the drug could tolerate at least 600 mg of peanut protein, the amount in two or three peanuts, compared to only 7% of those receiving placebo. Similar proportions of patients showed improvement in their reactions to the other foods in the study.

The authors write: “In persons as young as 1 year of age with multiple food allergies, omalizumab treatment for 16 weeks was superior to placebo in increasing the reaction threshold for peanut and other common food allergens.”

Omalizumab was also safe and did not cause side effects other than some instances of minor reactions at the site of injection.

Because people with food allergies also frequently experience other allergic conditions treated by omalizumab – such as asthma, allergic rhinitis (hay fever and allergies to environmental triggers), or eczema – it’s hoped that it may have the potential to improve all of their allergic conditions at once.

More research will now be needed to further understand how the drug regime could be implemented for these patients.

“We have a lot of unanswered questions: How long do patients need to take this drug? Have we permanently changed the immune system? What factors predict which people will have the strongest response?” says Chinthrajah.

“We don’t know yet.”

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