IgE-immunoadsorption for severe allergy to multiple foods: A case series of five children

Arasi, Stefania; Piscitelli, Anna Lucia; Cafarotti, Arianna; Marziani, Beatrice; Pecora, Valentina; Dahdah, Lamia; Leone, G; Bracaglia, Giorgia; Porzio, Ottavia; Muda, Andrea Onetti; Fiocchi, Alessandro

doi:10.1016/j.waojou.2023.100750

Cited by 3 publications

(10 citation statements)

References 27 publications

(47 reference statements)

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“…IgE‐immunoadsorption 37 resulted in improvements in the PedsQL score (from 70 ± 7.1 to 90 ± 1.4), although significance is not reported.…”

Section: Resultsmentioning

confidence: 89%

“…The population in question was adults in three studies, 22,31,35 children in 7, 20,21,30,33,34,36,37 and both in 9 16,23–29,32 …”

Section: Resultsmentioning

confidence: 99%

“…Finally, IgE‐immunoadsorption was tested in 5 children with IgE‐mediated food allergy to at least 2 foods and total IgE levels >2300 kUI/L, two of whom had concomitant hazelnut allergy 37 . Both children passed an OFC to hazelnut 1 day after IgE‐immunoadsorption discontinuation.…”

Section: Resultsmentioning

confidence: 99%

“…30 The PedsQL-questionnaire scores were significantly increased after 4 months of treatment in both parents (61 ± 5.32 to 87 ± 7.33) and patients (from 65 ± 7.39 to 90 ± 4.54), with greater improvement in the physical-health-summary score and the psychosocial-health-summary score. 32 IgE-immunoadsorption 37 resulted in improvements in the PedsQL score (from 70 ± 7.1 to 90 ± 1.4), although significance is not reported.…”

Section: Quality Of Life Assessmentmentioning

confidence: 86%

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Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Pasioti,

Xepapadaki,

Mathioudakis

et al. 2024

Pediatric Allergy Immunology

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Tree nut allergy is a lifelong and potentially life‐threatening condition. The standard of care is strictly avoiding the culprit nut and treating accidental reactions symptomatically. To evaluate potential therapeutic options for desensitizing patients with IgE‐mediated tree nut allergy, we systematically searched three bibliographic databases for studies published until January 2024. We looked for active treatments of IgE‐mediated allergy to tree nuts (walnut, hazelnut, pistachio, cashew, almond, pecan, macadamia nut, and brazil nut). We focused on allergen‐specific immunotherapy (AIT) using oral (OIT), sublingual (SLIT), epicutaneous (EPIT), or subcutaneous (SCIT) delivery, or other disease‐modifying treatments. We found 19 studies that met our criteria: 3 studies investigated sublingual immunotherapy, 5 studied oral immunotherapy to a single tree nut, and 6 used multi‐food oral immunotherapy with or without omalizumab. The remaining studies investigated the effectiveness of monoclonal antibodies or IgE‐immunoadsorption in multi‐food allergic patients, including patients with tree nut allergy. The heterogeneity of the studies prevented pooling and meta‐analysis. Oral immunotherapy, single or multi‐nut, with or without omalizumab, was the most studied approach and appears effective in conferring protection from accidental exposures. Omalizumab monotherapy is the only approved alternative management for reducing allergic reactions that may occur with accidental exposure.image

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“…IgE‐immunoadsorption 37 resulted in improvements in the PedsQL score (from 70 ± 7.1 to 90 ± 1.4), although significance is not reported.…”

Section: Resultsmentioning

confidence: 89%

“…The population in question was adults in three studies, 22,31,35 children in 7, 20,21,30,33,34,36,37 and both in 9 16,23–29,32 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Quality Of Life Assessmentmentioning

confidence: 86%

See 2 more Smart Citations

Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Pasioti,

Xepapadaki,

Mathioudakis

et al. 2024

Pediatric Allergy Immunology

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“…2,3 For patients with high tIgE, we regularly performed IgE immunoapheresis introductory to omalizumab treatment until September 2019. 4,5 However, postmarketing observational studies suggested that omalizumab efficacy is conserved also in asthmatic patients with tIgE >1500 UI/L without any significant side effect. 1,6,7 Recently, omalizumab has also shown promising results in the treatment of food allergies reducing the IgE levels and inhibiting mast cell activation upon exposure to food allergens.…”

mentioning

confidence: 99%

Omalizumab in severe asthma and food allergies with IgE levels >1500 kU/L: Two‐year evaluation

Dinardo,

Cafarotti,

Galletta

et al. 2023

Pediatric Allergy Immunology

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Omalizumab reduces anaphylactic reactions and allows food introduction in food‐allergic in children with severe asthma: An observational study

Arasi,

Cafarotti,

Galletta

et al. 2024

Allergy

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BackgroundIn Europe, Omalizumab (anti‐IgE) is indicated for the treatment of moderate to severe asthma, but not for IgE‐mediated food allergy (FA).ObjectiveWe assessed the impact of Omalizumab on efficacy, safety, and quality of life (FA‐QoL) in patients with moderate to severe asthma and who have a history of anaphylaxis to peanut, tree nuts, fish, egg, milk, and/or wheat.MethodsFood‐allergic children (6–18 years) with moderate to severe asthma underwent oral food challenges (OFCs) to establish the threshold of reaction to the culprit food(s) at baseline (T0) and at 4‐month intervals (T1, T2, and T3) during their first year of treatment with Omalizumab. We recorded the number and severity of food‐allergic reactions, Asthma Control Test (ACT) scores, FA‐QoL, and total IgE levels.ResultsIn 65 patients allergic to 107 foods, the No Observed Adverse Events Level (NOAEL) at T1 increased: 243‐ and 488‐fold for fresh and baked milk, respectively; 172‐ and 134‐fold for raw and baked egg; 245‐fold for hazelnut; 55‐fold for peanut; 31‐fold for wheat; and 10‐fold for fish. Full tolerance was achieved in 66.4% of OFCs at T1, 58.3% at T2, and 75% at T3. Ninety‐five foods were liberalized in the diet of 55 patients; the remaining 12 were introduced by 10 patients at least in traces. Throughout the study, 40 out of 65 were able to get a free diet. ACT increased from 17 (Q1‐Q3: 15–17) to 23.6 (Q1‐Q3: 23–25). The FA‐QoL score in children ≤12 years decreased from 4.63 ± 0.74 to 2.02 ± 1.13, and in adolescents from 4.68 ± 0.92 to 1.90 ± 1.50.ConclusionsDuring Omalizumab therapy, a safe reintroduction of allergenic foods is feasible.Trial Registration NumberClinicalTrials.gov, NCT06316414.

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IgE-immunoadsorption for severe allergy to multiple foods: A case series of five children

Cited by 3 publications

References 27 publications

Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Omalizumab in severe asthma and food allergies with IgE levels >1500 kU/L: Two‐year evaluation

Omalizumab reduces anaphylactic reactions and allows food introduction in food‐allergic in children with severe asthma: An observational study

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