4.7 Review

Treatment for food allergy: Current status and unmet needs

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Phase 2, randomized multi oral immunotherapy with omalizumab 'real life' study

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Summary: This study aimed to determine the minimum daily dose that can achieve desensitization and induce immune responses in multi-food oral immunotherapy (mOIT). The results showed that even at a total protein dose of 300 mg inclusive of multiple allergens, combined with a fixed-dose of omalizumab, early plasma marker changes can be induced.

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Updating the CoFAR Grading Scale for Systemic Allergic Reactions in Food Allergy

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Summary: Immunotherapy for food allergy is promising, but adverse events and their severity during treatment are not standardized. This study developed a revised grading scale to categorize and assess adverse allergic reactions in food allergy clinical trials. The use of this revised scale would allow for better data aggregation and safety comparisons.

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Advances, Practical Implementation, and Unmet Needs Regarding Oral Immunotherapy for Food Allergy

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Summary: The treatment of food allergies is continuously evolving, and oral immunotherapy (OIT) has emerged as a significant advancement in recent years. There is a growing demand for OIT, especially for allergens like peanut, egg, and milk, which have substantial evidence of efficacy. However, there are still important questions surrounding the treatment of multiple and less common food allergies, as well as the long-term safety and effectiveness of OIT.

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Summary: Omalizumab as an adjunct to food allergen oral immunotherapy has shown potential in reducing the time needed to reach maintenance dosing and adverse events, although serious adverse events may still occur. Limited long-term data suggest a risk of increased reactivity after discontinuation of omalizumab. Further studies are needed to optimize protocols and identify patients who will benefit the most.

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Natasha Purington et al.

Summary: The use of time-to-event methodology in food allergy trials allows for a more detailed evaluation of treatment efficacy over time, incorporating information for those who failed or were lost to follow up. This approach provides a dose-time outcome that is interpretable to clinicians and allows for examination of outcomes over time.

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Mayu Maeda et al.

Summary: The study found that oral immunotherapy significantly reduced allergic symptoms in children with severe cow's milk allergy, but the incidence of adverse events was relatively high, suggesting the need for further research on safety in order to standardize OIT for cow's milk allergy.

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Improvement in Health-Related Quality of Life in Food-Allergic Patients: A Meta-Analysis

Shu Cao et al.

Summary: This meta-analysis found that both oral immunotherapy (OIT) and oral food challenges (OFCs) are associated with an improvement in health-related quality of life (HRQoL) in patients with food allergies. Further well-designed and long-term studies are needed to confirm the sustained benefits of OIT and OFCs.

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O. Pfaar et al.

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Effect of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein Ingestion Among Children With Peanut Allergy The PEPITES Randomized Clinical Trial

David M. Fleischer et al.

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A drug safety review of treating eosinophilic asthma with monoclonal antibodies

Patrick Mitchell et al.

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Multicenter, randomized, double-blind, placebo-controlled clinical trial of vital wheat gluten oral immunotherapy

Anna Nowak-Wegrzyn et al.

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Anti-IgE treatment with oral immunotherapy in multifood allergic participants: a double-blind, randomised, controlled trial

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Early oral immunotherapy in peanut-allergic preschool children is safe and highly effective

Brian P. Vickery et al.

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Omalizumab facilitates rapid oral desensitization for peanut allergy

Andrew J. MacGinnitie et al.

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Safety and feasibility of oral immunotherapy to multiple allergens for food allergy

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The safety and efficacy of sublingual and oral immunotherapy for milk allergy

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Kinetics of mast cell, basophil, and oral food challenge responses in omalizumab-treated adults with peanut allergy

Jessica H. Savage et al.

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