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2025-07-18

Eat without fear: anti-ige antibody omalizumab, a new weapon against food allergies

Allergology and Immunology

#Omalizumab #FoodAllergies #IgE #Anaphylaxis #Immunotherapy  


Food allergies: a persistent therapeutic dead end  


Food allergies affect approximately 10% of children in industrialized countries. Common allergens include peanuts, tree nuts, eggs, and milk. While symptoms are sometimes mild, the risk of severe or even fatal reactions demands strict allergen avoidance and constant vigilance.  

Currently, the only “solution” is total allergen avoidance combined with the use of emergency medication kits. Some forms of oral desensitization exist, but they are lengthy, burdensome, and typically limited to a single allergen. For polysensitized or highly reactive patients, no widely accessible alternative has been available—until now.  


Targeting IgE: omalizumab’s smart approach  


Omalizumab is a monoclonal antibody initially developed for severe allergic asthma. Its mechanism is simple: it binds to free IgE in the bloodstream, preventing it from attaching to immune cells (mast cells, basophils). As a result, the allergic reaction cascade is halted before it even begins.  

This approach is particularly promising for IgE-mediated food allergies, as it could raise the threshold required to trigger a reaction—even in cases of accidental ingestion. Unlike allergen-specific desensitization, Omalizumab’s effect is broad, making it suitable for children with multiple food allergies.  


A pivotal study: striking results  


The 2025 OUtMATCH clinical trial evaluated Omalizumab’s efficacy in 180 children allergic to peanuts and at least one other food. Participants received the treatment for 16 weeks without changing their diets, and were then exposed to peanuts in a controlled setting.
  The results were striking:

  • 67% of treated children tolerated a dose of 600 mg of peanut protein, versus only 7% in the placebo group.
  • The drug was also effective against other allergens, such as cashew nuts and milk.

Omalizumab significantly reduced allergen sensitivity, even without parallel desensitization. Its rapid (within weeks) and cross-allergen effectiveness marks a turning point in allergy management.  


A well-tolerated treatment, easy to implement  


Omalizumab is administered via subcutaneous injections every 2 to 4 weeks and has a favorable safety profile. Side effects are generally mild (e.g., local reactions, headaches), and the protocol does not require a specialized hospital setting.  

This convenient administration and good tolerability make it an ideal candidate for routine practice—especially to secure the daily lives of at-risk children. For families, this means less anxiety, more freedom, and significantly reduced risk in the event of accidental exposure.  

Read next: Unsung conductors of food tolerance


A new option, as complement or alternative  


Omalizumab’s potential doesn’t end there. It may also help facilitate oral desensitization protocols by reducing reactions during the induction phase. Previous studies have already demonstrated this synergy, paving the way for faster and better-tolerated treatments.  

Moreover, the treatment could expand therapeutic options for patients previously excluded from interventions—such as young children, highly sensitive individuals, or those allergic to multiple foods.    


A Game-Changing Breakthrough  


For the first time, a drug appears capable of actively protecting against food allergies—without requiring progressive allergen exposure.  

Future studies will need to confirm long-term efficacy, clarify reimbursement conditions, and assess cost-effectiveness. But one thing is clear: Omalizumab represents a true breakthrough, offering a preventive, targeted, and widely applicable therapeutic approach.  


Conclusion: from survival to freedom  


Food allergies should no longer mean isolation or constant fear. Thanks to scientific advances like those involving Omalizumab, thousands of families can regain hope. By targeting IgE, this treatment ushers in a new era—where allergic children can eat, play, and live like everyone else, without overwhelming anxiety or extreme restrictions.  

Read next: Unsung conductors of food tolerance





Source(s) :
Savage, J., et al. (2024). Omalizumab for the Treatment of Multiple Food Allergies (OUtMATCH). New England Journal of Medicine, 390(9), 847–857. ;

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