000565 - Omalizumab for oral desensitization in children with cow's milk allergy

Cow's milk protein allergy (CMPA) is the most frequent food allergy in children. 

Conservative treatment consists in the avoidance of the allergen, with the resulting detriment to the quality of life of the patient and  parents.

Food immunotherapy (OIT) is potentially a curative treatment that can increase the amount of food tolerated by the patient and prevent allergic symptoms.

In patients who present an adverse reaction during tolerance induction or in whom a high risk is assumed, adjuvant treatment with anti-IgE (omalizumab) may be used.

Our aim is to evaluate the efficacy and safety of omalizumab (OMZ) in children with severe CMPA. We present three case reports of patiens who underwent OIT. The use of omalizumab was decided after detecting a recent adverse reaction at home or during the initiation phase of OIT.

Information regarding clinical and laboratory findings is provided. Skin tests, IgE, IgG4 specific for milk were performed.

OIT has been successful in 2 of 3 patients.  They currently have a free diet with dairy ingestion of 200 ml cow's milk. A patient developed a non-IgE mediated allergy when OIT was being finalized (non-immediate vomiting) 

In patients who completed the procedure, no adverse effect was observed after administration of omalizumab or during the induction phase. Specific IgE levels have decreased, and specific IgG4 levels have increased.

 OMZ treatment has demonstrated its efficacy in increasing the threshold of tolerance in several studies, and has made it possible to achieve tolerance in our patients without any adverse effects attributable to omalizumab.