JACI

AAAAI 2025: Omalizumab outperforms oral immunotherapy in multi-food allergy treatment

March 4, 2025

Omalizumab may be a viable alternative to oral immunotherapy (OIT) for treating multi-food allergies, particularly for patients who experience severe reactions to OIT, according to findings presented at the American Academy of Allergy, Asthma & Immunology (AAAAI)/World Allergy Organization (WAO) Joint Congress in San Diego, CA.

Study details: Stage 2 of the OUtMATCH trial directly compared omalizumab with OIT for the first time. At 10 U.S. locations, 177 children and adolescents (ages 1-17) and three adults (ages 18-55) with confirmed allergies to less than half a peanut and ≥2 other common foods were enrolled. After the first stage, 117 participants received 8 weeks of omalizumab injections. They were then randomized into 2 groups: Group A received omalizumab and multi-allergen OIT for eight weeks, followed by placebo injections and OIT for 44 weeks; Group B received omalizumab and placebo OIT for 8 weeks, followed by omalizumab and placebo OIT for 44 weeks.

Results: Omalizumab was more effective than OIT for treating multi-food allergies in patients with low initial tolerance. By the end of treatment, 36% of participants on omalizumab tolerated ≥2 grams of peanut protein and 2 other allergens, compared with 19% on OIT (odds ratio, 2.6; P = 0.031). Omalizumab also showed superiority for success with ≥2 foods (P = 0.004) and other secondary endpoints. No differences were found in the per-protocol analysis. Serious adverse events, treatment discontinuations, and epinephrine-treated events were more common in the OIT group.

Sources:

Wood, R., et al. (2025, February). The Journal of Allergy and Clinical Immunology. Treatment of Multi-Food Allergy with Omalizumab Compared to Omalizumab-Facilitated Multi-Allergen OIT. https://www.jacionline.org/article/S0091-6749(24)02309-1/fulltext

(2025, March 3). NIH. Omalizumab treats multi-food allergy better than oral immunotherapy. https://www.nih.gov/news-events/news-releases/omalizumab-treats-multi-food-allergy-better-oral-immunotherapy