A groundbreaking clinical trial has revealed that omalizumab, commonly known as Xolair, demonstrates superior efficacy in treating multi-food allergies compared to oral immunotherapy (OIT). This study, which focused on individuals with severe allergic reactions to minute quantities of common food allergens, found that 36% of participants treated with omalizumab could tolerate significant amounts of peanut protein and two other food allergens by the end of the treatment period. In contrast, only 19% of those undergoing OIT achieved similar results. The findings were unveiled at a major allergy congress in San Diego on March 2, 2025, and published in an online supplement to The Journal of Allergy and Clinical Immunology.

The research involved a comprehensive examination of two therapeutic approaches for managing multi-food allergies. Omalizumab, a medication that targets immunoglobulin E antibodies, was administered to participants who exhibited highly sensitive reactions to foods such as peanuts, tree nuts, eggs, milk, and wheat. Initially, all participants received omalizumab injections for eight weeks before being randomly assigned to one of two groups. Group A continued with omalizumab alongside multi-allergen OIT, while Group B received omalizumab with placebo OIT.

During the trial, it became evident that omalizumab significantly reduced the risk of adverse reactions associated with OIT. Among the 59 participants in Group A, 29 discontinued therapy due to intolerable side effects or other reasons. Conversely, none of the 58 participants in Group B experienced allergic reactions from omalizumab, although seven left the study for logistical reasons. Ultimately, 36% of Group B members successfully tolerated at least 2 grams of peanut protein and two other allergens, whereas only 19% of Group A achieved this milestone.

When focusing solely on participants who completed the entire course of treatment, both groups showed comparable outcomes. However, the overall effectiveness of omalizumab stood out, primarily because fewer participants discontinued treatment due to side effects. This suggests that omalizumab offers a safer and more reliable alternative for those with multi-food allergies, particularly when initial tolerance levels are very low.

The trial's success highlights a promising new avenue for treating multi-food allergies. With omalizumab proving to be more effective and better tolerated, healthcare providers now have a valuable tool to help patients manage their allergies more effectively. The study's findings underscore the importance of exploring diverse treatment options and pave the way for further advancements in allergy management strategies.