New treatment options are revolutionizing ways to manage and reduce the effects of food allergies. Biologics—medications that come from living organisms as opposed to lab-made conventional drugs—are making a profound impact in the realm of food allergy after omalizumab became the first biologic to receive approval from the FDA in February 2024. Now, This UNC School of Medicine study is weighing the pros and cons of how providers perceive the role of biologics and their range of possibilities.
Led by co-authors Edwin Kim, MD, Division Chief of Pediatric Allergy and Immunology, director of the UNC Food Allergy Initiative, and Jill Fisher, PhD, professor in the UNC Department of Social Medicine and UNC Center for Bioethics, the study was published in the Annals of Allergy, Asthma and Immunology.
Findings were clustered into four main themes including how providers perceived the benefits of biologics, ideal use of biologics, concerns about biologics, and biologics perceived as the future of food allergy care. Results showed how community and academic providers saw biologics as an option for food allergy patients beyond avoiding the food, or the specialized food-based oral immunotherapy, with particular benefit for difficult to treat groups such as adolescents and young adults, those with multiple food allergies, and those numerous allergic diseases.
While emphasizing the benefits of biologics, providers were highly concerned about the safety and efficacy of biologics, their potential for inappropriate use and overuse, and their cost to patients and the U.S. healthcare system. Due to these concerns, the study revealed how providers expressed their desire to see evidence for how to best use biologics, including whether they might be best on their own or in combination with oral immunotherapy and food-based treatments.
“I share a lot of the same hopes as well as concerns for biologics,” said Kim, who has children with food allergies. “Finding a good deal of agreement between community and academic allergy providers was a little surprising and overall reassuring that perspectives and practice patterns for food allergy may be similar across practice sites.”
Could this new age of biologics restructure the future of drug discovery and food allergy treatment? The study concludes that most providers were enthusiastic, even calling it a “turning point.” Researchers believe the arrival of biologics will change how food allergy care is practiced, and a review of these perspectives gives a snapshot of how the therapy is perceived.
“By highlighting the expected benefits as well as the concern for biologics that providers have, in a way it provides a road map for future therapies, both in which therapies might be developed and also in how they are rolled out,” said Kim. “With omalizumab now approved and available for patients, it will be important to see if the expected benefits hold true in particular for those more difficult groups. In addition, seeing if the concerns for overuse and cost will come true and any safeguards that can be created to protect against this will also be important for the future of food allergy treatments.”
