Both omalizumab and oral immunotherapy are used to treat multiple food allergies. A study was conducted in 2024 to compare the effectiveness of the two treatments to help patients and allergists make appropriate treatment decisions.
The study included 117 patients with confirmed peanut allergy and at least two other foods (eggs, milk, wheat, cashews, walnuts, and hazelnuts). All participants initially received omalizumab injections for 8 weeks. Then they were randomly divided into two groups:
- Group A received omalizumab injections and multi-food oral immunotherapy for 8 weeks. Then, participants received placebo injections and multi-food oral immunotherapy for 44 weeks, with doses increasing to 1000 mg of each allergen.
- Group B received omalizumab injections and placebo oral immunotherapy for 8 weeks. Then, participants continued to receive omalizumab injections and placebo oral immunotherapy for 44 weeks.
Next, the participants underwent a challenge test to see if they were able to eat at least 2 grams of peanut protein (about 8 peanuts) and their two other study foods without an allergic reaction.
The results of the study were as follows:
- During the study period, 29 of the 59 participants in group A discontinued treatment due to side effects, intolerable symptoms of oral immunotherapy, and other reasons. While 7 participants in group B left due to study burden.
- 21 of the original 58 participants in group B could tolerate at least 2 grams of all three foods.
- Only 11 of the original 59 participants in group A could tolerate at least 2 grams of each of their allergens.
The researchers concluded that omalizumab was more effective than oral immunotherapy in treating multi-food allergies and was well tolerated, but oral immunotherapy remains an effective option if the side effects of oral immunotherapy are not an issue.
