The Role of Biologics in the Treatment of Food Allergy.

The landscape of food allergy (FA) treatment is poised for a paradigm shift with the emergence of biologic therapies. The FDA approval of a standardized peanut Powder for oral immunotherapy (OIT) in 2020 marked a milestone, signaling a departure from allergen avoidance toward proactive treatment strategies. While OIT has been proven effective in desensitizing patients to specific allergens, there are several limitations such as lacking standardization, a long-time commitment to achieve maintenance, and adverse events. Biologics, including omalizumab, dupilumab, and anti-alarmins, have shown promise in treating various allergic diseases, including FA. These biologics target the underlying immunological pathways driving allergic reactions, offering an antigen-agnostic approach. Omalizumab (anti-IgE) has been the most studied biologic in this space and can be utilized both as an adjunct therapy with OIT or as monotherapy. Dupilumab targeting IL-4 and IL-13 also shows promise as an adjunct therapy. The emergence of anti-alarmins further broadens the spectrum of FA treatment possibilities. Biologics represent a transformative approach to FA treatment, directly addressing the underlying mechanisms. Future research should focus on patient selection criteria, personalized biomarker panels, optimal timing of intervention, and treatment durations.