1. Determinants of omalizumab dose–related efficacy in oral immunotherapy: Evidence from a cohort of 181 patients
- Author
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Pauline Azzano, Guy Parizeault, Louis Paradis, Jonathan Lacombe-Barrios, Anne Des Roches, Kathryn Samaan, Maxime Paquin, François Graham, Alexandra Langlois, Philippe Bégin, and Charles Morin
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Dose ,medicine.medical_treatment ,Immunology ,Administration, Oral ,Context (language use) ,Omalizumab ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,Dosing ,Child ,030223 otorhinolaryngology ,Survival analysis ,Desensitization (medicine) ,business.industry ,Immunoglobulin E ,medicine.disease ,3. Good health ,Desensitization, Immunologic ,Cohort ,Female ,business ,Food Hypersensitivity ,030215 immunology ,medicine.drug - Abstract
Background Omalizumab has been shown to improve the safety and feasibility of oral immunotherapy (OIT), but the optimal dosage strategy is unknown. Objective Our aim was to identify determinants of omalizumab dose–related efficacy in the context of OIT. Methods The study sample consisted of a clinical cohort of 181 patients treated with omalizumab-enabled oral immunotherapy at 3 centers. Patients received omalizumab for at least 2 months before an initial food escalation (IFE) with a mix of up to 6 allergens. Progression through IFE steps was assessed with survival analysis. Continued food dose tolerance with omalizumab weaning was also documented. Results Omalizumab dosage per weight alone was strongly associated with progression through the IFE (χ2 = 28.18; P Conclusion In the context of OIT and IgE-mediated disease, omalizumab dosages should be adjusted for body weight alone, independently of total IgE level. The fraction of allergen-specific/total IgE may be useful to predict patients at greater risk of food dosing reactions subsequent to weaning.
- Published
- 2021
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