Indolfi Cristiana, Perrotta Alessandra, Dinardo Giulio, Klain Angela, Grella Carolina, Palumbo Paola, Miraglia Del Giudice Michele
Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy.
Life (Basel). 2025 Apr 22;15(5):681. doi: 10.3390/life15050681.
Omalizumab (OMA) is gaining recognition as a promising therapeutic approach for IgE-mediated food allergies in pediatric patients. We conducted a review analyzing 22 studies, including randomized controlled trials, observational studies, and case reports, to evaluate the efficacy and safety of OMA in food allergy management in children and adolescents. The results indicate that OMA, whether used as monotherapy or in combination with oral immunotherapy (OIT), significantly increases allergen tolerance, reduces the severity of allergic reactions, and improves patients' quality of life. When used alongside OIT, OMA reduced adverse reactions during dose escalation and maintenance phases, facilitating safer and more effective desensitization. Additionally, OMA demonstrated benefits beyond food allergy management, including improved asthma control and a reduction in food allergy-related anxiety. However, challenges remain, including high costs, the need for standardized treatment protocols, and limitations related to total IgE thresholds for eligibility. While OMA has been FDA-approved for food allergy treatment in the United States, further research is needed to establish long-term efficacy, optimal dosing strategies, and its role in sustained tolerance development. Future research should focus on optimizing treatment protocols and identifying which patients will benefit the most. Integrating omalizumab into food allergy management could revolutionize pediatric care, offering hope for a safer, more effective approach to desensitization.
奥马珠单抗（OMA）作为一种治疗儿童IgE介导的食物过敏的有前景的治疗方法正逐渐得到认可。我们进行了一项综述，分析了22项研究，包括随机对照试验、观察性研究和病例报告，以评估OMA在儿童和青少年食物过敏管理中的疗效和安全性。结果表明，OMA无论是作为单一疗法还是与口服免疫疗法（OIT）联合使用，都能显著提高过敏原耐受性，降低过敏反应的严重程度，并改善患者的生活质量。与OIT同时使用时，OMA在剂量递增和维持阶段减少了不良反应，促进了更安全、更有效的脱敏。此外，OMA还显示出食物过敏管理之外的益处，包括改善哮喘控制和减少与食物过敏相关的焦虑。然而，挑战仍然存在，包括成本高昂、需要标准化的治疗方案以及与总IgE阈值相关的资格限制。虽然OMA已在美国获得FDA批准用于食物过敏治疗，但仍需要进一步研究以确定其长期疗效、最佳给药策略及其在持续耐受性发展中的作用。未来的研究应专注于优化治疗方案并确定哪些患者将受益最大。将奥马珠单抗纳入食物过敏管理可能会彻底改变儿科护理，为更安全、更有效的脱敏方法带来希望。
