Abstract

Allergen immunotherapy (AIT) remains the only disease-modifying treatment for IgE-mediated disorders. The combination of AIT with biologic agents represents a promising therapeutic approach, offering enhanced efficacy, safety and clinical outcomes in the management of severe allergic conditions such as food allergy, asthma, rhinitis and hymenoptera venom allergy. Notably, existing evidence in pediatric populations predominantly focuses on omalizumab. However, there are no standardized protocols for the combined use of AIT and biological drugs.

References

  1. Tosca MA, Ferrecchi C, D’Ambrosio T, et al. Predicting and overcoming poor patient responses to sublingual immunotherapy for allergic diseases. Expert Opin Biol Ther 2025;25:821-833. https://doi.org/10.1080/14712598.2025.2531035.
  2. Zuberbier T, Wood RA, Bindslev-Jensen C, et al. Omalizumab in IgE-Mediated Food Allergy: A Systematic Review and Meta-Analysis. J Allergy Clin Immunol Pract 2023;11:1134-1146. https://doi.org/10.1016/j.jaip.2022.11.036.
  3. Shen W, Zhou Q, Zhang Q, et al. Efficacy and safety of omalizumab combined with allergen immunotherapy in children with moderate to severe allergic asthma. Int Forum Allergy Rhinol 2025;15:208-211. https://doi.org/10.1002/alr.23470.
  4. Sindher SB, Fiocchi A, Zuberbier T, et al. The Role of Biologics in the Treatment of Food Allergy. J Allergy Clin Immunol Pract 2024;12:562-568. https://doi.org/10.1016/j.jaip.2023.11.032.
  5. Larenas-Linnemann D, Diamant Z, Jesenak M, et al. Combination of Allergen-Specific Immunotherapy with Biologics in Severe Asthma: Counterintuitive or Rational? J Allergy Clin Immunol Pract 2025;13:1581-1596. https://doi.org/10.1016/j.jaip.2025.05.003.
  6. Wood RA, Togias A, Sicherer SH, et al. Omalizumab for the Treatment of Multiple Food Allergies. N Engl J Med 2024;390:889-899. https://doi.org/10.1056/nejmoa2312382.
  7. Indolfi C, Perrotta A, Dinardo G, et. Omalizumab in Food Allergy in Children: Current Evidence and Future Perspectives. Life (Basel) 2025;15:681. https://doi.org/10.3390/life15050681.
  8. Buono EV, Giannì G, Scavone S, et al. Omalizumab and Oral Immunotherapy in IgE-Mediated Food Allergy in Children: A Systematic Review and a Meta-Analysis. Pharmaceuticals (Basel) 2025;18:437. https://doi.org/10.3390/ph18030437.
  9. Schuetz JP, Anderson B, Sindher SB. New biologics for food allergy. Curr Opin Allergy Clin Immunol 2024;24:147-152. https://doi.org/10.1097/aci.0000000000000981.
  10. Chinthrajah RS, Sindher SB, Nadeau KC, et al. Dupilumab as an Adjunct to Oral Immunotherapy in Pediatric Patients with Peanut Allergy. Allergy 2025;80:827-842. https://doi.org/10.1111/all.16420.
  11. Riggioni C, Oton T, Carmona L, et al. Immunotherapy and biologics in the management of IgE-mediated food allergy: Systematic review and meta-analyses of efficacy and safety. Allergy 2024;79:2097-2127. https://doi.org/10.1111/all.16129.
  12. Guan D, Liu Y, Gu Y, Zheng B, et al. Efficacy and Safety of Specific Immunotherapy Combined with Biologics in Allergic Rhinitis and Asthma: A Systematic Review and Network Meta-Analysis. Int Arch Allergy Immunol 2025;186:851-869. https://doi.org/10.1159/000543023.
  13. Ridolo E, Pellicelli I, Kihlgren P, et al. Immunotherapy and biologicals for the treatment of allergy to Hymenoptera stings. Expert Opin Biol Ther 2019;19:919-925. https://doi.org/10.1080/14712598.2019.1632286.

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Authors

Chiara Ferrecchi - Department of Pediatrics, Allergy Center, Istituto Giannina Gaslini (IRCCS), Genoa, Italy https://orcid.org/0009-0008-7948-9051

Vincenzo Meleca - Department of Pediatrics, Allergy Center, Istituto Giannina Gaslini (IRCCS), Genoa, Italy

Matteo Naso - Department of Pediatrics, Allergy Center, Istituto Giannina Gaslini (IRCCS), Genoa, Italy

Chiara Trincianti - Department of Pediatrics, Allergy Center, Istituto Giannina Gaslini (IRCCS), Genoa, Italy

Roberta Olcese - Department of Pediatrics, Allergy Center, Istituto Giannina Gaslini (IRCCS), Genoa, Italy

Maria Angela Tosca - Department of Pediatrics, Allergy Center, Istituto Giannina Gaslini (IRCCS), Genoa, Italy

How to Cite
Ferrecchi, C., Meleca, V., Naso, M., Trincianti, C., Olcese, R. ., & Tosca, M. A. (2026). Allergen Immunotherapy and Biologics. Italian Journal of Pediatric Allergy and Immunology, 39(4). https://doi.org/10.53151/2531-3916/2025-1688
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