Determinants of omalizumab dose–related efficacy in oral immunotherapy: Evidence from a cohort of 181 patients

Omalizumab has been shown to improve the safety and feasibility of oral immunotherapy (OIT), but the optimal dosage strategy is unknown. Our aim was to identify determinants of omalizumab dose–related efficacy in the context of OIT. The study sample consisted of a clinical cohort of 181 patients tre...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 2021-01, Vol.147 (1), p.233-243
Main Authors: Azzano, Pauline, Paquin, Maxime, Langlois, Alexandra, Morin, Charles, Parizeault, Guy, Lacombe-Barrios, Jonathan, Samaan, Kathryn, Graham, François, Paradis, Louis, Des Roches, Anne, Bégin, Philippe
Format: Article
Language:English
Subjects:
Continued consumption
desensitization
dosage
food allergy
OIT
omalizumab
oral immunotherapy
pharmacokinetics
pharmacokinetics and pharmacodynamics
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Summary:Omalizumab has been shown to improve the safety and feasibility of oral immunotherapy (OIT), but the optimal dosage strategy is unknown. Our aim was to identify determinants of omalizumab dose–related efficacy in the context of OIT. The study sample consisted of a clinical cohort of 181 patients treated with omalizumab-enabled oral immunotherapy at 3 centers. Patients received omalizumab for at least 2 months before an initial food escalation (IFE) with a mix of up to 6 allergens. Progression through IFE steps was assessed with survival analysis. Continued food dose tolerance with omalizumab weaning was also documented. Omalizumab dosage per weight alone was strongly associated with progression through the IFE (χ2 = 28.18; P 
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2020.08.039