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Allergen immunotherapy as add-on to biologic agents

Lombardi, Carloa; Canonica, Giorgio W.b; Passalacqua, Giovannic

Current Opinion in Allergy and Clinical Immunology: December 2018 - Volume 18 - Issue 6 - p 502–508
doi: 10.1097/ACI.0000000000000479
IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush

Purpose of review In this review, we sought to outline many of the recent evidences about the available clinical trials in which biologic agents [i.e. omalizumab (OMA)] were associated as add-on to allergen-specific immunotherapy (AIT).

Recent findings The available literature shows that OMA may be a valuable option as add-on to AIT for respiratory allergy, or food desensitization, especially in the escalation or build-up phases, in which adverse events are more commonly expected. The encouraging data for hymenoptera venom allergy remain limited to case reports, and no structured clinical trial is available.

Summary Over the past decade, studies of OMA used with AIT have shown promising results. Today, big randomized, double-blind, placebo-controlled trials are needed to better select those patients who would benefit from the addition of OMA (or other biologic agents) to AIT, as well as optimal dosing schedules, optimal duration of treatments and, finally, adequate evaluation about pharmacoeconomic aspects.

aDepartmental Unit of Allergology & Pneumology, Fondazione Poliambulanza Hospital, Brescia

bPersonalized Medicine Asthma & Allergy Clinic, Humanitas University and Research Hospital, Milano

cAllergy and Respiratory Diseases, Policlinico San Martino, University of Genoa, Genoa, Italy

Correspondence to Carlo Lombardi, MD, Departmental Unit of Allergology & Pneumology, Fondazione Poliambulanza Hospital, Brescia, Italy. Tel: +39 030 3518555; e-mail:

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