Emerging therapeutics in the management of food allergy

Food allergy therapy has experienced rapid growth over the past five years. In addition to avoidance measures and reactive treatment of accidental exposures, physicians can now offer patients multiple therapies for reducing the risk of severe reactions upon accidental exposure, and potentially achieving sustained remission. Many promising therapies are also in the pipeline. In this review, we outline the clinical management of food allergy, including mainstream non-pharmaceutical therapies, such as food oral immunotherapy (OIT), as well as three FDA-approved therapies: Palforzia (pharmaceutical peanut oral immunotherapy), omalizumab (anti-IgE monoclonal antibody), and Neffy (intranasal epinephrine). We also discuss emerging therapies, including novel routes of immunotherapy administration (epicutaneous, subcutaneous, sublingual, oral mucosal) and existing immunomodulatory therapies undergoing trials for use in food allergy, including dupilumab (anti-IL-4 and IL-13 monoclonal antibody), abrocitinib (oral JAK inhibitor) and abatacept (IgG-CTLA-4 fusion protein).