A prospective cohort study evaluated an omalizumab-facilitated OIT protocol designed to allow direct initiation at maintenance dosing for most foods in 100 children and young adults, following at least 8 weeks of omalizumab pretreatment, with a median follow-up of 27.6 weeks.
94% of initiation challenges were tolerated (181/193); 97% of patients started daily dosing for at least one food, and 84% started at target maintenance doses for all foods. Only 2 patients (2%) discontinued due to adverse events; adverse events occurred in 40%, most commonly abdominal pain (23%) and oral pruritus (13%).
- Single-arm prospective cohort with no control group, limiting causal inference. - Relatively short median follow-up (~27.6 weeks); long-term durability after omalizumab discontinuation is unknown. - Study conducted at what appears to be a single center, which may limit generalizability.
For children and young adults undergoing multi-food OIT, pretreatment with omalizumab for ~12 weeks may allow most patients to skip gradual up-dosing and start directly at maintenance doses, reducing clinic visits and treatment burden. Adverse events were mostly mild and rarely led to discontinuation.
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