Omalizumab Outshines Oral Immunotherapy in Multi-Food Allergy Treatment: Study Reveals - Video

A clinical trial has found that the medication omalizumab, marketed as Xolair, treated multi-food allergy more effectively than oral immunotherapy (OIT) in people with allergic reactions to very small amounts of common food allergens. OIT, the most common approach to treating food allergy, involves eating gradually increasing doses of a food allergen to reduce the allergic response to it.

The findings were published in an online supplement to

The Journal of Allergy and Clinical Immunology and presented at the 2025 American Academy of Allergy, Asthma & Immunology/World Allergy Organization Joint Congress.

The study team enrolled 177 children and adolescents ages 1 to 17 years and three adults ages 18 to 55 years, all with confirmed allergy to less than half a peanut and similarly small amounts of at least two other common foods among milk, egg, cashew, wheat, hazelnut or walnut. After completing the first stage of the trial, 117 individuals entered the second stage of the trial.

It was found that 36% percent of study participants who received an extended course of omalizumab could tolerate 2 grams or more of peanut protein, or about eight peanuts, and two other food allergens by the end of the treatment period, but only 19% of participants who received multi-food OIT could do so. Researchers attributed this difference primarily to the high rate of allergic reactions and other intolerable side effects among the participants who received OIT, leading a quarter of them to discontinue treatment. When the participants who discontinued therapy were excluded from the analysis, however, the same proportion of each group could tolerate at least 2 grams of all three food allergens.

These results showed that omalizumab was more effective than OIT at treating multi-food allergy in people who originally had a very low tolerance to common food allergens. Investigators attributed this outcome mainly to the high rate of allergic reactions and other side effects leading to treatment discontinuation among the OIT-treated participants, despite receiving omalizumab before and during the early months of therapy.

Ref: RA Wood et al. Treatment of multi-food allergy with omalizumab compared to omalizumab-facilitated multi-allergen OIT. Journal of Allergy and Clinical Immunology DOI: 10.1016/j.jaci.2024.12.1022 (2025).