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Food allergy is familiar territory in primary care, but the therapeutic landscape is changing quickly. For years, our conversations with families centered on avoidance, label reading, emergency action plans, and ready access to epinephrine. Those remain essential. Yet, newer therapies now offer something different: the possibility of increasing the amount of allergen needed to trigger a reaction and thereby reducing some of the risk associated with accidental exposure. The recent randomized clinical trial by Wood et al.1 brings that shift into especially sharp focus. In patients with multiple food allergies, continued omalizumab treatment was more successful than omalizumab-facilitated multiallergen oral immunotherapy in the intention-to-treat analysis, largely because adverse events and treatment discontinuations limited completion of oral immunotherapy.
