Omalizumab boosts allergy tolerance: Study

In promising news for food allergy sufferers, a new treatment option is emerging in the United States, using the already available injection, omalizumab.
 
Researchers at the Johns Hopkins Children’s Center found the asthma treatment can substantially reduce potentially life-threatening reactions for those with common allergies.
 
The study comprised of 180 participants aged between one and 55 years old, all with a history of peanut allergy and at least two other food allergies.
 
After four months, 67% of patients treated with omalizumab were able to tolerate around 2.5 peanuts, compared to 7% of participants who received placebo injections.
 
Omalizumab also increased participants’ threshold to several other food allergens, including milk, eggs, wheat, cashews, walnuts, and hazelnuts.
 
Most participants in the omalizumab trial group were able to tolerate 15 peanuts and almost half could eat 25 peanuts.
 
Johns Hopkins Children’s Center researcher Dr Robert Wood said the study’s results will change lives.
 
‘The day-to-day life of patients with food allergy is consumed by fear of accidental exposure to food allergens,’ he said.
 
‘Our findings have the potential to be very meaningful, and potentially even life changing, for people with food allergies.’
 
RACGP Specific Interests Allergy Chair Dr Nicholas Cooling told newsGP while the treatment is a long way off being approved for use in Australia, it is a space to watch.
 
‘We don’t really have any perfect methods at the moment for curing food allergies, and so that’s why any new study is interesting, but it’s not the complete answer to the problem,’ he said.
 
‘Hardly any of these methods, apart from naturally growing out of a food allergy, gives you complete protection against the food.
 
‘People need to know that a lot of studies are being done in Australia at the moment, and although there’s still no cure for food allergies, many of these studies are showing hope.’
 
Around 10% of all Australian children and up to 4% of adults live with a food allergy, with the most common being egg, dairy, peanut, tree nuts, sesame, soy, wheat, fish, and other seafood. 
 
Australia has one of the highest rates of food allergy in the world, with the number of children with a food allergy or food-related immune disorder soaring over the past decade.
 
Dr Cooling said GPs have a big role in preventing food allergy.
 
‘They can do that through a number of ways, including when they’re talking to pregnant mums about the importance of breastfeeding and having adequate vitamin D,’ he said.
 
‘They can also ensure that when their patient delivers their baby, they have a healthy baby that’s been breastfed and that they’re looking after their microbiome.
 
‘GPs also need to make sure they encourage the early introduction of allergenic foods into the infants’ diet after they start solids, which is usually around the age of five or six months.’
 
Food allergies continue to threaten the lives of thousands of Australians, with anaphylaxis presentations to public hospital emergency departments doubling in the five years to 2019–20, while overall hospital admissions increased by 35%.
 
Dr Cooling’s advice to GPs is to stay up to date with current and evolving allergy medicine, with best-practice care standards undergoing a significant transformation in recent years.
 
‘In the past, we’ve tried to avoid a load of foods but that’s not recommended now because it worsens or increases the risk of food allergies,’ he said.
 
‘GPs can do a lot in stopping this epidemic by encouraging good health promotion, and then if they do find a child with a food allergy, they need to refer to an allergist, or a GP allergist, or a paediatrician.’
 
Further information can be found in the RACGP’s ‘Excluding allergenic foods in maternal and infant diets’ resource.
 
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