A Phase 2 Randomized Controlled Multisite Study Using Omalizumab-facilitated Rapid Desensitization to Test Continued...

Area of Science:

• Allergy and Immunology
• Immunotherapy
• Food Allergy Research

Background:

• Limited data exists on the long-term sustainability of multifood-oral immunotherapy (OIT).
• This study aimed to compare desensitization efficacy between sustained and discontinued dosing after multifood-OIT.

Purpose of the Study:

• To evaluate the sustainability of desensitization achieved through multifood-OIT.
• To compare the efficacy of continued maintenance dosing versus discontinuation of multifood-OIT.

Main Methods:

• 70 participants (aged 5-22) with multiple food allergies were enrolled.
• Participants received omalizumab and multifood-OIT, followed by randomization to 1 g, 300 mg, or 0 mg dosing arms.
• Success was defined as passing a 2 g food challenge to at least two foods.

Main Results:

• Continued dosing (1 g or 300 mg) was more effective (85%) than OIT discontinuation (55%) in maintaining desensitization.
• Cross-desensitization was observed between certain tree nut pairs (cashew/pistachio, walnut/pecan).
• No significant safety differences were found between the dosing arms.

Conclusions:

• Sustained desensitization after omalizumab-facilitated multifood-OIT is best achieved through continued maintenance dosing.
• Dosing of 300 mg or 1 g of each food allergen is recommended over OIT discontinuation for sustained efficacy.
• Further research may explore optimal maintenance strategies for multifood-OIT.