Robert Wood, MD

HCPLive Five – Allergy Updates at AAAAI 2025

 2025 Academy of Allergy, Asthma, & Immunology (AAAAI) 

annual meeting in San Diego to connect with colleagues, explore late-breaking data, and attend hundreds of sessions.

 Allergy Team reported live from San Diego, conducting dozens of interviews and covering late-breaking research. In this iteration of the HCPLive Five, the team highlighted standout video interviews, covering topics such as insect allergy testing, chronic rhinosinusitis, omalizumab for food allergies, oral immunotherapy with autoclaved peanuts, and the WAYPOINT phase 3 trial assessing tezepelumab for nasal polyp management.

When to Test for Insect Sting Allergies, with David Golden, MD

David Golden, MD, from Johns Hopkins University, discussed the pitfalls of over-testing for insect sting allergies. He emphasized that a positive test does not confirm an allergy, as many people with positive results experience no reaction to stings.

Testing should be reserved for patients with anaphylactic reactions, as unnecessary testing can lead to undue worry and even disqualify individuals from opportunities like military service. Unlike peanut allergies, insect allergy tests do not predict reaction severity, making it crucial for clinicians to avoid misinterpreting strong test results as indicators of severe allergy risk.

When an Allergist Should Refer Endoscopic Sinus Surgery for Chronic Rhinosinusitis, with Kent Lam, MD

Kent Lam, MD, from Eastern Virginia Medical School at Old Dominion University, discussed when allergists should refer patients with chronic rhinosinusitis for endoscopic sinus surgery; surgery is recommended when symptoms persist despite treatment with topical steroids, saline irrigation, or antibiotics.

The procedure aims to improve sinus drainage and ventilation rather than remove tissue. Lam emphasized setting patient expectations regarding risks such as bleeding, scarring, and symptom persistence.

Omalizumab Performs Better Than Oral Immunotherapy for Food Allergy, with Robert Wood, MD

Robert Wood, MD, from Johns Hopkins Medicine, discussed the OUtMATCH trial comparing omalizumab and oral immunotherapy (OIT) for food allergies. The study found omalizumab superior in the intent-to-treat analysis (36% vs 19%;

 = .031), but per-protocol analysis—excluding dropouts—showed similar effectiveness (

OIT had a high dropout rate due to side effects, while omalizumab was well tolerated. Wood emphasized the need for individualized treatment, as OIT may offer long-term immune changes, but omalizumab provides a safer alternative with fewer side effects.

Patients Tolerate Oral Immunotherapy Better with Autoclaved vs Blanched Peanuts, with Casey Cohen, PhD

A study found that peanut-allergic patients tolerated oral immunotherapy better with autoclaved peanuts than with blanched peanuts. Casey Cohen, PhD, from McGill University, explained that autoclaving—using high temperature and pressure—reduces peanut-specific immunoglobulin binding, resulting in fewer severe reactions.

In a double-blind trial of 10 participants, the median tolerated dose was significantly higher for autoclaved peanuts (300 mg vs. 9 mg). No participants required epinephrine for autoclaved peanuts, whereas all were for blanched peanuts.

Tezepelumab Lowers Nasal Polyp Severity in CRSwNP During Phase 3 WAYPOINT, with Joseph Han, MD

The phase 3 WAYPOINT trial demonstrated that tezepelumab significantly reduced nasal polyp severity in patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP), lowering the need for surgery by 92%. Tezepelumab significantly improved nasal congestion, sense of smell, and overall symptom scores at 52 weeks.

Investigator Joseph Han, MD, from Eastern Virginia Medical School, highlighted the near elimination of surgery in the treatment group. These findings support tezepelumab as a promising treatment option for CRSwNP, reducing reliance on systemic steroids and surgical intervention.

GlaxoSmithKline, Regeneron Pharmaceuticals, and AstraZeneca Pharmaceuticals for Lam, Genentech USA for Wood, none for Cohen, and GlaxoSmithKline, Genzyme Corporation, Regeneron Healthcare Solutions, Medtronic, Merck Sharp & Dohme, Optinose, AstraZeneca Pharmaceuticals, Aerin Medical, and PFIZER for Han.

Videos

Counting down the most impactful news at major medical meetings, it’s the HCPLive Five! This episode focuses on 5 key allergy updates from the 2025 American Academy of Allergy, Asthma, and Immunology (AAAAI) annual meeting.


2025 American Academy of Allergy, Asthma, & Immunology (AAAAI) 

 spoke with Robert Wood, MD, from Johns Hopkins Medicine, on OUtMATCH—a trial comparing the effectiveness of omalizumab vs oral immunotherapy for food allergies.

had 177 participants (55% males; the median age of 7 years who were allergic to peanuts and ≥ 2 other common food allergens, such as milk, egg, cashew, wheat, walnut, or hazelnut. Participants started with omalizumab injections and at week 9 were randomized to receive oral immunotherapy or placebo oral immunotherapy (maintenance goal: 1,000 mg). At week 16, participants entered the double-blind portion, where they were randomized to receive either omalizumab or a placebo injection for 44 weeks. The therapy was considered successful if participants tolerated 4,044 mg of all 3 of their food allergens post-treatment.

In the intent-to-treat analysis, omalizumab demonstrated superiority over oral immunotherapy (36% vs 19%; odds ratio [OR]; 

 = .031). However, the per-protocol analysis, which analyzed the treatment’s effectiveness without examining dropouts, found no differences between omalizumab and oral immunotherapy for food allergy management (P = .66).

“When we do an intent to treat analysis, what happens is that anyone who drops out of the treatment for any reason is considered a treatment failure,” Wood told HCPLive. “And in this stage 2 of the outmatch study, there was a very low rate of dropouts in the omalizumab side of the study and quite a high rate of dropouts in the multi-allergen OIT slide of the side of the study. What that did really is drive the results toward the advantage of omalizumab. If we look only at the patients who could stay on oral immunotherapy, the results were very similar, and that's the per-protocol analysis.”

He said the results underline the importance of an individualized treatment approach. A patient may tolerate their food allergen better after omalizumab or oral immunotherapy—it all depends on how the patient reacts.

“What I would take away from this is that oral immunotherapy does have potential benefit, but we need to be very clear with our patients about the high rate of side effects and the possibility that they really won't tolerate that treatment, whereas with omalizumab, we don't see side effect,” Wood said. “While [omalizumab] doesn't have the potential for long-term changes in the immune system that oral immunotherapy has, it's a very effective treatment for most patients with a very low risk of side effects.”

Wood, R, Jones, S, Dantzer, J, et al. Treatment of Multi-Food Allergy with Omalizumab Compared to Omalizumab-Facilitated Multi-Allergen OIT. Journal of Allergy and Clinical Immunology, Volume 155, Issue 2, AB444. 

https://www.jacionline.org/article/S0091-6749(24)02309-1/fulltext

Derman, C.Omalizumab Outperforms Oral Immunotherapy for Food Allergies in Johns Hopkins Study. HCPLive. March 2, 2025. 

https://www.hcplive.com/view/omalizumab-outperforms-oral-immunotherapy-food-allergies-johns-hopkins-study

Although omalizumab demonstrated superiority over oral immunotherapy, the treatments had comparable effectiveness when excluding dropouts from the analysis, Wood said at AAAAI.

Robert Wood, MD

Articles