Omalizumab in the Management of Food Allergy – a Narrative Review of Data from Clinical Studies, Case Series and Case Reports

Jankowski, W.M., Przychodniak, D. & Kurowski, M. Curr Treat Options Allergy 12, 19 (2025). https://doi.org/10.1007/s40521-025-00399-8

Abstract

Purpose of Review

Food allergy is a significant public health problem, affecting 8% of children and 3–4% of adults, with potentially life-threatening anaphylaxis being its most severe manifestation. Trigger food avoidance is still the mainstay of food allergy management, while novel treatments, including specific allergen immunotherapy and omalizumab, a humanized IgG1κ antibody, have shown potential to reduce the risk of allergic reaction after food ingestion. The purpose of this review is to provide an account of current knowledge regarding efficacy and safety profile of omalizumab in the management of food allergy, implemented as a standalone treatment or in combination with oral immunotherapy of food allergy.

Recent Findings

Food protein threshold values after OMA or placebo treatment

Current data indicate that omalizumab significantly increases the threshold of tolerance to food allergens in children, reducing the risk of severe anaphylactic reactions.

In the omalizumab-treated groups, a higher percentage of patients achieved higher tolerance thresholds to allergens such as peanuts, cashew nuts, eggs, milk, walnuts, hazelnuts and wheat, compared to the placebo groups. In addition, omalizumab in combination with OIT allows for safer allergen dose escalation.

Summary

Omalizumab is proving to be an effective and safe drug for the treatment of food allergies, especially when combined with OIT. It can significantly improve patients' quality of life by minimizing the risk of accidental exposure to allergens and reducing allergy-related stress. However, further studies are needed to fully evaluate its long-term safety and efficacy, in particular in the adult food allergic population.

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