Impact of Omalizumab on Food Allergy in Patients Treated for Asthma

A Real-Life Study

Alessandro Fiocchi, Maria Cristina Artesani, Carla Riccardi, Maurizio Mennini, Valentina Pecora, Vincenzo Fierro, Veronica Calandrelli, Lamia Dahdah, Rocco Luigi Valluzzi

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The effects of omalizumab on food allergy thresholds have been little studied.

OBJECTIVE: To assess the real-life effects of omalizumab on food threshold tolerability in children treated for severe asthma.

METHODS: In this observational, real-life, efficacy study, we reviewed the food allergen thresholds of patients with severe asthma, as well as their immediate reactions to 2+ foods before and after a 4-month treatment with omalizumab. We also evaluated their control of asthma and their quality of life, as measured by Pediatric Quality of Life Inventory (PedsQL).

RESULTS: Fifteen children, allergic to 37 foods, were evaluated. Omalizumab induced an increase in the allergen threshold for milk, egg, wheat, and hazelnut from a mean 1012.6 ± 1464.5 mg protein to 8727 ± 6463.3 eliciting dose (P < .001). A total of 70.4% of subjects tolerated the complete challenge dose after 4 months of treatment with omalizumab. These foods were reintroduced in the patients' diet without the need for any oral immunotherapy procedures. The remaining foods were partially tolerated. The number of reactions to the unintended ingestion of allergenic foods over 4 months dropped from 47 to 2. The PedsQL increased from 61 ± 5.32 to 87 ± 7.33 (parental judgment; P < .001) and from 65 ± 7.39 to 90 ± 4.54 (patients' judgment; P < .001). The mean cost of omalizumab was €1311.63 per month.

CONCLUSIONS: During treatment with omalizumab for severe uncontrolled asthma, the food allergen threshold increases to 8.6 times its original value. The quality of life of patients also increased, due to a better asthma control and a reduction in dietary restrictions. The cost/benefit ratio of such treatment for selected cases of food allergy remains to be evaluated.

Original languageEnglish
JournalJournal of Allergy and Clinical Immunology: In Practice
DOIs
Publication statusE-pub ahead of print - Feb 20 2019

Fingerprint

Food Hypersensitivity
Asthma
Food
Allergens
Quality of Life
Corylus
Omalizumab
Therapeutics
Immunotherapy
Triticum
Cost-Benefit Analysis
Ovum
Milk
Eating
Pediatrics
Diet
Costs and Cost Analysis
Equipment and Supplies

Cite this

@article{ec04166ae9c74a3191273afe4f14b9de,
title = "Impact of Omalizumab on Food Allergy in Patients Treated for Asthma: A Real-Life Study",
abstract = "BACKGROUND: The effects of omalizumab on food allergy thresholds have been little studied.OBJECTIVE: To assess the real-life effects of omalizumab on food threshold tolerability in children treated for severe asthma.METHODS: In this observational, real-life, efficacy study, we reviewed the food allergen thresholds of patients with severe asthma, as well as their immediate reactions to 2+ foods before and after a 4-month treatment with omalizumab. We also evaluated their control of asthma and their quality of life, as measured by Pediatric Quality of Life Inventory (PedsQL).RESULTS: Fifteen children, allergic to 37 foods, were evaluated. Omalizumab induced an increase in the allergen threshold for milk, egg, wheat, and hazelnut from a mean 1012.6 ± 1464.5 mg protein to 8727 ± 6463.3 eliciting dose (P < .001). A total of 70.4{\%} of subjects tolerated the complete challenge dose after 4 months of treatment with omalizumab. These foods were reintroduced in the patients' diet without the need for any oral immunotherapy procedures. The remaining foods were partially tolerated. The number of reactions to the unintended ingestion of allergenic foods over 4 months dropped from 47 to 2. The PedsQL increased from 61 ± 5.32 to 87 ± 7.33 (parental judgment; P < .001) and from 65 ± 7.39 to 90 ± 4.54 (patients' judgment; P < .001). The mean cost of omalizumab was €1311.63 per month.CONCLUSIONS: During treatment with omalizumab for severe uncontrolled asthma, the food allergen threshold increases to 8.6 times its original value. The quality of life of patients also increased, due to a better asthma control and a reduction in dietary restrictions. The cost/benefit ratio of such treatment for selected cases of food allergy remains to be evaluated.",
author = "Alessandro Fiocchi and Artesani, {Maria Cristina} and Carla Riccardi and Maurizio Mennini and Valentina Pecora and Vincenzo Fierro and Veronica Calandrelli and Lamia Dahdah and Valluzzi, {Rocco Luigi}",
note = "Copyright {\circledC} 2019. Published by Elsevier Inc.",
year = "2019",
month = "2",
day = "20",
doi = "10.1016/j.jaip.2019.01.023",
language = "English",
journal = "Journal of Allergy and Clinical Immunology: In Practice",
issn = "2213-2198",
publisher = "American Academy of Allergy, Asthma and Immunology",

}

TY - JOUR

T1 - Impact of Omalizumab on Food Allergy in Patients Treated for Asthma

T2 - A Real-Life Study

AU - Fiocchi, Alessandro

AU - Artesani, Maria Cristina

AU - Riccardi, Carla

AU - Mennini, Maurizio

AU - Pecora, Valentina

AU - Fierro, Vincenzo

AU - Calandrelli, Veronica

AU - Dahdah, Lamia

AU - Valluzzi, Rocco Luigi

N1 - Copyright © 2019. Published by Elsevier Inc.

PY - 2019/2/20

Y1 - 2019/2/20

N2 - BACKGROUND: The effects of omalizumab on food allergy thresholds have been little studied.OBJECTIVE: To assess the real-life effects of omalizumab on food threshold tolerability in children treated for severe asthma.METHODS: In this observational, real-life, efficacy study, we reviewed the food allergen thresholds of patients with severe asthma, as well as their immediate reactions to 2+ foods before and after a 4-month treatment with omalizumab. We also evaluated their control of asthma and their quality of life, as measured by Pediatric Quality of Life Inventory (PedsQL).RESULTS: Fifteen children, allergic to 37 foods, were evaluated. Omalizumab induced an increase in the allergen threshold for milk, egg, wheat, and hazelnut from a mean 1012.6 ± 1464.5 mg protein to 8727 ± 6463.3 eliciting dose (P < .001). A total of 70.4% of subjects tolerated the complete challenge dose after 4 months of treatment with omalizumab. These foods were reintroduced in the patients' diet without the need for any oral immunotherapy procedures. The remaining foods were partially tolerated. The number of reactions to the unintended ingestion of allergenic foods over 4 months dropped from 47 to 2. The PedsQL increased from 61 ± 5.32 to 87 ± 7.33 (parental judgment; P < .001) and from 65 ± 7.39 to 90 ± 4.54 (patients' judgment; P < .001). The mean cost of omalizumab was €1311.63 per month.CONCLUSIONS: During treatment with omalizumab for severe uncontrolled asthma, the food allergen threshold increases to 8.6 times its original value. The quality of life of patients also increased, due to a better asthma control and a reduction in dietary restrictions. The cost/benefit ratio of such treatment for selected cases of food allergy remains to be evaluated.

AB - BACKGROUND: The effects of omalizumab on food allergy thresholds have been little studied.OBJECTIVE: To assess the real-life effects of omalizumab on food threshold tolerability in children treated for severe asthma.METHODS: In this observational, real-life, efficacy study, we reviewed the food allergen thresholds of patients with severe asthma, as well as their immediate reactions to 2+ foods before and after a 4-month treatment with omalizumab. We also evaluated their control of asthma and their quality of life, as measured by Pediatric Quality of Life Inventory (PedsQL).RESULTS: Fifteen children, allergic to 37 foods, were evaluated. Omalizumab induced an increase in the allergen threshold for milk, egg, wheat, and hazelnut from a mean 1012.6 ± 1464.5 mg protein to 8727 ± 6463.3 eliciting dose (P < .001). A total of 70.4% of subjects tolerated the complete challenge dose after 4 months of treatment with omalizumab. These foods were reintroduced in the patients' diet without the need for any oral immunotherapy procedures. The remaining foods were partially tolerated. The number of reactions to the unintended ingestion of allergenic foods over 4 months dropped from 47 to 2. The PedsQL increased from 61 ± 5.32 to 87 ± 7.33 (parental judgment; P < .001) and from 65 ± 7.39 to 90 ± 4.54 (patients' judgment; P < .001). The mean cost of omalizumab was €1311.63 per month.CONCLUSIONS: During treatment with omalizumab for severe uncontrolled asthma, the food allergen threshold increases to 8.6 times its original value. The quality of life of patients also increased, due to a better asthma control and a reduction in dietary restrictions. The cost/benefit ratio of such treatment for selected cases of food allergy remains to be evaluated.

U2 - 10.1016/j.jaip.2019.01.023

DO - 10.1016/j.jaip.2019.01.023

M3 - Article

JO - Journal of Allergy and Clinical Immunology: In Practice

JF - Journal of Allergy and Clinical Immunology: In Practice

SN - 2213-2198

ER -