Food allergies remain a major challenge, especially for those allergic to multiple foods like peanut and others. Oral immunotherapy (OIT) helps build tolerance, but side effects - particularly gastrointestinal symptoms - often limit success.
The COMBINE trial, presented at AAAAI 2026, tested adding dupilumab (a biologic blocking IL-4/IL-13 pathways, already used for asthma/eczema) to omalizumab-assisted multi-allergen OIT in 108 patients.
The good news: Dupilumab dramatically boosted desensitization. At the 32-week mark, 92% of patients on the dupilumab combo tolerated a high 4,043 mg peanut allergen dose during challenges—compared to just 63% without it.
The caveat: It didn't significantly increase sustained unresponsiveness (long-term tolerance off therapy) - 55% vs. 39%, not statistically different.
This could help patients who struggle with GI reactions or miss doses, but real-world use faces hurdles like cost and access. Ongoing work aims to uncover biomarkers to predict responders and refine biologic strategies for food allergy.
References:
https://www.hcplive.com/view/dupilumab-improves-desensitization-outcomes-oit-sayantani-sindher-md