Oral immunotherapy and the novel therapy omalizumab have helped revolutionize the management of food allergies. Researchers at the 2026 AAAAI Annual Meeting presented new data from several studies on these impactful interventions and on investigational novel therapies for food allergies.

Following these presentations, featured expert Jacob D. Kattan, MD, was interviewed by Conference Reporter Associate Editor-in-Chief Mona Shah, PharmD. Clinical perspectives from Dr Kattan on these findings are presented here.

As recently as 10 to 15 years ago, we really did not have many treatment options for food allergies other than an epinephrine autoinjector and food allergen avoidance. However, multiple treatments have become available in the clinic over the past decade, with more therapeutic options on the way. The first one that comes to mind is oral immunotherapy (OIT), with small amounts of the food allergen given daily to desensitize patients over time. And we also now have omalizumab, which was approved by the US Food and Drug Administration (FDA) in 2024 for food allergy treatment, providing some protection against accidental food allergen ingestion, as we saw in the OUtMATCH study.

At the recent 2026 AAAAI Annual Meeting, several studies, such as those by Hao Tseng, MD, and colleagues (abstract 441) and R. Sharon Chinthrajah, MD, FAAAAI, et al (abstract L22), were presented evaluating the use of omalizumab for the prevention of allergic reactions to food allergens and in other scenarios, including as a potential intervention that would help us add food allergens to the diet. If we can do successful oral food challenges for patients on omalizumab and if they are able to tolerate significant amounts of these foods, we can then try to enable them to incorporate those foods into their diets.

The OUtMATCH study by Kari Nadeau, MD, PhD, FAAAAI, and colleagues was also presented at this year’s AAAAI meeting, with new data on the immune effects that are observed when omalizumab is used in conjunction with OIT (abstract 802). We have seen from studies that when we combine OIT with omalizumab, patients are able to reach maintenance dosing more often. They have fewer allergic reactions to the therapy with fewer side effects reported as they increase their doses. There was another very interesting study by Sayantani Sindher, MD, FAAAAI, et al presented at the meeting that looked at combining dupilumab and OIT with omalizumab and showed a reduction in the gastrointestinal reactions and side effects that we see with OIT (abstract L11).

Questions that still remain when using omalizumab with OIT are: Should patients try to discontinue omalizumab? And, if so, when (eg, after they have reached their maintenance dose of the OIT)? I think that some studies are starting to look at this.

Remibrutinib is another potential intervention for food allergies. It is an oral small-molecule therapy that can be administered in pill form and may not take very long to exert its effects. A very early study of remibrutinib by Robert Wood, MD, FAAAAI, and colleagues presented at the 2026 AAAAI Annual Meeting looking at adults with peanut allergies demonstrated favorable safety and efficacy profiles (abstract 563). I do think that there are certainly limitations to this, however. It was a small study over a short time, and it was only looking at adults with peanut allergies. However, the data were still exciting, and further studies are warranted. This type of therapy could be helpful for people who, for example, are about to go on a trip and want some protection or are about to go to sleepaway camp and might be able to start treatment in the weeks prior to their need for protection.

Finally, also at AAAAI 2026, Scott Sicherer, MD, FAAAAI, gave a talk on the clinical implications of the results from the recently published CAFETERIA study. Unlike most food allergy studies, which typically include patients who are highly allergic, the CAFETERIA trial targeted people who were not highly allergic to peanuts for OIT. What was amazing about this study was that, in a relatively short amount of time, patients were able to achieve a high rate of sustained unresponsiveness, meaning that they finished the OIT and still showed a high amount of desensitization or, potentially, tolerance. So, maybe we should not just target the most allergic children. Maybe we can open up free eating for those who are not as severely allergic but are still impeded by their food allergies.

It is exciting that we went from really having no treatments to offer families in the clinic 10 years ago to now having discussions on which of these therapies might be best for each patient. We now have choices and can move toward personalized medicine. Promising data presented at AAAAI 2026 on peanut epicutaneous immunotherapy (abstract 560) and peanut sublingual immunotherapy (abstract 559) indicate that we will probably have additional therapies to offer patients with food allergies in the coming years.