The new drug helps prevent serious allergic reactions to various foods, such as peanuts and milk.

A new drug may prevent dangerous allergic reactions to a small number of foods that cause allergies in adults and children, such as peanuts or milk, according to a new study conducted by scientists at the Stanford School of Medicine (USA).

The study was published in the New England Journal of Medicine. The results suggest that regular use of the drug omalizumab may protect people from serious allergic reactions, such as difficulty breathing, if they accidentally eat small amounts of a food they are allergic to.

“I am very pleased that we have a promising new treatment for patients with multiple food allergies. This new approach has shown really good responses to many allergic foods,” said lead study author Dr. Sharon Chintraja, assistant professor of medicine and pediatrics and acting director of the Sean N. Parker Center for Allergy and Asthma Research at Stanford University School of Medicine.

“Patients with food allergies face the daily threat of life-threatening reactions due to accidental exposure,” said senior study author Dr. Robert Wood, professor of pediatrics at Johns Hopkins University School of Medicine. “The study showed that omalizumab may provide a layer of protection against small incidental exposures,” he said.

Omalizumab, which the US Food and Drug Administration (FDA) initially approved to treat conditions such as allergic asthma and chronic urticaria, binds to antibodies that cause many types of allergic diseases and is inactive. Based on data collected in the new study, the FDA approved omalizumab on February 16 to reduce the risk of food allergic reactions.

All study participants had severe allergies to peanuts and at least two other foods, such as milk, eggs, wheat, cashews, hazelnuts or walnuts.

After four months of monthly or bimonthly omalizumab injections, two-thirds of the 118 participants who received the drug safely ate small amounts of the foods they were allergic to.

Notably, 38.4 percent of study participants were under 6 years of age, an age group at high risk for accidentally eating allergy-producing foods.

Allergies are common

Food allergies affect approximately 8 percent of children and 10 percent of adults in the United States. People with severe allergies are advised to completely avoid foods containing allergy triggers, but common allergens such as peanuts, milk, eggs and wheat can be hidden in so many places that everyday activities such as attending parties and eating at restaurants may be affected. complex.

“Food allergies have serious social and psychological consequences, including the threat of allergic reactions upon accidental exposure, some of which can be life-threatening,” says Chintraja. Families also face the economic consequences of buying more expensive products to avoid allergens, he added.

In the best food allergy treatment available—oral immunotherapy—patients eat tiny amounts, gradually increasing doses of the allergy-causing foods under a doctor’s supervision to build tolerance.

But oral immunotherapy itself can cause allergic reactions, desensitization to allergens can take months or years, and the process is especially lengthy for people with multiple food allergies since they are usually treated one at a time.

After desensitization to an allergen, patients must continue to eat these foods regularly to maintain tolerance, but they often do not like the foods they had to avoid for a long time.

“There is a real need for treatment that goes beyond observation and offers options for our food allergy patients,” Chintraja said.

Omalizumab is an injectable antibody that binds to and inactivates all types of immunoglobin E, or IgE, an allergy-causing molecule in the body’s blood and immune cells. At the moment, omalizumab is able to alleviate allergies to several food allergens at once. “We think the effect should be the same regardless of the food,” Chintraja said.

Injections prevent serious reactions

The study included 177 children with at least three food allergies each, of whom 38 percent were between 1 and 5 years of age, 37 percent were between 6 and 11 years of age, and 24 percent were 12 years of age or older.

At retest, 79 patients (66.9%) taking omalizumab could tolerate at least 600 mg of peanut protein (the amount found in two or three peanuts), compared with only four patients (6.8%) taking placebo. A similar number of patients had improved responses to other products in the study.

About 80 percent of patients taking omalizumab were able to consume small amounts of at least one allergenic food without causing an allergic reaction, 69 percent of patients were able to consume small amounts of two allergenic foods, and 47 percent of patients taking small amounts of all three allergenic foods .

Omalizumab was safe and did not cause side effects, except for a few cases of mild injection site reactions. The safety of this study was first assessed in children aged one year.

We must continue to investigate

The researchers say further research is needed to better understand how omalizumab may help people with food allergies.

“We have a lot of unanswered questions: How long should patients take this drug? Have we permanently changed the immune system? What factors predict which people will have the strongest reaction?” says Chintraja. “We still don’t know,” he concluded.

The team is planning studies to answer these and other questions, such as what type of follow-up will be needed to determine when a patient has developed significant tolerance to the allergic food.

Chintraja noted that many patients with food allergies also have other allergic conditions that are treated with omalizumab, such as asthma, allergic rhinitis (hay fever and allergies to environmental pathogens such as mold, dogs or cats, or dust mites) or eczema. “A drug that can improve all allergic conditions is exactly what we are hoping for,” he said.

“The drug may be particularly useful for young children with severe food allergies, as they tend to put things in their mouths and may not realize the dangers of their allergies,” he added.

The drug may also make it safer for family doctors. “This is something our food allergy community has been waiting for a long time,” says Chintraja. “This pharmacological regimen is easy to implement in the medical office, and many allergists are already using it for other allergic conditions,” he noted.