A small-scale clinical study has revealed that dupilumab, a monoclonal antibody that inhibits interleukin-4 and interleukin-13 signaling, significantly reduces immunoglobulin E (IgE) levels in patients with food allergies. The findings suggest potential new applications for the biologic therapy beyond its currently approved indications.
The study, presented at the American Academy of Dermatology (AAD) 2025 Annual Meeting, evaluated the impact of dupilumab on allergen-specific IgE levels in patients with confirmed food allergies. Participants receiving dupilumab demonstrated marked reductions in IgE antibodies specific to their food allergens compared to baseline measurements.
"These results are particularly encouraging as they suggest dupilumab may directly impact the immunological mechanisms underlying food allergies," said the lead investigator, whose team measured IgE levels before treatment initiation and at multiple intervals throughout the study period.
Mechanism of Action and Clinical Implications
Dupilumab works by blocking key inflammatory pathways involved in type 2 immune responses, which are implicated in allergic conditions. By inhibiting IL-4 and IL-13 signaling, the drug appears to downregulate IgE production, potentially reducing allergic sensitivity to food triggers.
The study builds upon dupilumab's established efficacy in related conditions. Currently, the medication is approved for treating moderate to severe atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyps, and eosinophilic esophagitis. This new data suggests its therapeutic potential may extend to IgE-mediated food allergies, which affect approximately 32 million Americans.
"What's particularly notable is the consistency of response across different food allergen types," explained an immunologist involved in the research. "We observed reductions in IgE specific to peanuts, tree nuts, and other common food allergens, suggesting a broad mechanism of action."
Study Design and Patient Outcomes
The trial enrolled patients with confirmed IgE-mediated food allergies who had previously failed conventional management approaches. Participants received standard dupilumab dosing (300 mg every two weeks following a loading dose) and underwent regular assessment of allergen-specific IgE levels.
Beyond laboratory measurements, researchers documented clinical improvements in allergic symptom burden. Several participants reported reduced severity of allergic reactions during accidental exposures to allergens, though the study was not designed to assess changes in clinical reactivity as a primary endpoint.
"While this was primarily a mechanistic study looking at biomarkers, the clinical observations are promising," noted one researcher. "However, larger controlled trials are needed before we can recommend dupilumab specifically for food allergy management."
Broader Therapeutic Landscape
The findings come as Sanofi and Regeneron's dupilumab (marketed as Dupixent) continues to expand its approved indications. Recently, a similar biologic, omlyclomab (Omlyclo), received approval for multiple allergic conditions including IgE-mediated food allergy, further validating the approach of targeting type 2 inflammation in allergic disorders.
Experts note that the food allergy treatment landscape has evolved significantly in recent years, with biologics representing a promising frontier for patients with severe or multiple food allergies. Traditional management has relied heavily on strict avoidance and emergency medications for accidental exposures.
"For patients with food allergies, especially those with multiple allergies or severe reactions, the psychological burden is enormous," said an allergist not involved in the study. "Any therapy that might reduce sensitivity or reaction severity could dramatically improve quality of life."
Safety Profile and Next Steps
The safety profile observed in the study was consistent with dupilumab's known safety data from larger trials in other indications. Common adverse events included injection site reactions and conjunctivitis, with no new safety signals identified.
Researchers emphasized that while promising, these results require validation in larger, randomized controlled trials specifically designed to assess clinical outcomes in food allergy patients. Such studies would need to evaluate whether the observed reductions in IgE translate to meaningful changes in allergic threshold or reaction severity.
"The next logical step would be controlled food challenges before and after treatment to determine if the immunological changes we're seeing translate to clinical protection," explained the principal investigator.
If confirmed in larger studies, these findings could potentially lead to new treatment options for the millions of patients living with food allergies, particularly those with severe or multiple allergies who face significant daily challenges and quality of life impairments.
