Indications for Biological Treatment Combined with Allergen-Specific Immunotherapy: Who Is It Really Intended for?

Allergen-specific immunotherapy (AIT) is a well-proven treatment for allergic diseases and conditions such as Hymenoptera venom allergy, allergic rhinitis, allergic asthma, and, in recent years, food allergy. In order to enhance the efficacy and safety of allergen immunotherapy, biological agents such as omalizumab and dupilumab have been introduced. The use of omalizumab, in combination with AIT, has proven to be an effective option in treating patients with allergic asthma and during food desensitization, particularly in the dose escalation phase when adverse reactions are more common. To date, only a small number of well-structured clinical trials have been published on the combined use of biologics and AIT in patients with Hymenoptera venom allergy. Ongoing clinical studies are evaluating the efficacy of dupilumab as monotherapy or as an adjunct therapy to oral immunotherapy in patients with peanut allergy. Research is also underway on the use of dupilumab in patients with multiple food allergies and as an adjunct therapy to oral immunotherapy in patients with cow's milk protein allergy. Further studies are needed to determine the optimal dosing and duration of biological therapy in combination with AIT, as well as to identify patients who may benefit most from such treatment regimes.