Allergy Month in Review: April 2025

Although April brought no regulatory changes in allergy medication, various journals published studies on allergy treatments or associations in the allergy field.

From new evidence supporting the effectiveness of omalizumab in IgE-mediated food allergy to a pediatric protocol improving anesthetic allergy diagnosis, the data reflect an evolving landscape. HCPLive also caught up with a certified clinical specialist in cardiovascular and pulmonary physical therapy who shared spring allergy tips for managing patients with overlapping respiratory issues.

This April Month in Review highlights 7 studies shaping the future of allergy care.

What’s Moving in the Allergy Pipeline

Aquestive’s Anaphylm for Severe Allergic Reactions Shows Promise in Children

On April 1, 2025, Aquestive Therapeutics announced positive topline results from its pediatric study of Anaphylm (epinephrine) sublingual film, showing a consistent pharmacokinetic profile in children aged 7-17 years, aligning with adult data. The study included 32 patients and marked the final trial in the company’s clinical program, supporting its recent New Drug Application (NDA) submission to the FDA. If approved, Anaphylm could become the first sublingual film treatment for severe allergic reactions, including anaphylaxis, with a potential launch in early 2026.

Hear from an Allergist on Spring Allergies

Spring Allergy Tips Clinicians Can Share with Patients, with Noah Greenspan, DPT, PT

Noah Greenspan, DPT, PT, CCS, EMT-B, a board-certified clinical specialist in cardiovascular and pulmonary physical therapy, shared spring 2025 allergy tips, especially for clinicians treating respiratory conditions such as asthma, COPD, or long COVID.

Greenspan emphasized that patients with pulmonary conditions may experience heightened symptoms, such as bronchospasms and airway narrowing. For those with long COVID, even minor allergen exposure can trigger overstimulation. He stressed prevention as the key strategy.

Promising Treatments on the Horizon

Real World Data Supports Omalizumab as Monotherapy for IgE-Mediated Food Allergy

Real-world data support omalizumab (Xolair) as an effective treatment for IgE-mediated food allergies, either as monotherapy or in combination with oral immunotherapy (OIT). A retrospective analysis of 62 European patients found an 83.9% overall response rate.

Notably, 82.4% of monotherapy patients responded positively, while combination therapy with OIT showed even greater response rates. These findings highlight omalizumab's potential to manage food allergies, though it remains unapproved for this indication in Europe.

Viaskin Patch Effective in Peanut-Allergic Kids with Atopic Comorbidities

A phase 3 trial found the Viaskin Peanut patch (VP250) effectively desensitized peanut-allergic children aged 1-3 years, even in the presence of atopic comorbidities including asthma, atopic dermatitis, or other food allergies. Children on VP250 had significantly greater responder rates than those on placebo, with no meaningful differences in efficacy across subgroups. Higher anaphylaxis rates were noted in those with atopic dermatitis or food allergies, underscoring the need for careful monitoring in these populations.

Selective Vidian Neurectomy Plus FESS Shows Long-Term Relief in Nasal Itching

A study found that combining functional endoscopic sinus surgery (FESS) with selective vidian neurectomy significantly improved long-term nasal symptom control in patients with allergic rhinitis, chronic rhinosinusitis with nasal polyps (CRSwNP), and asthma. Over 3 years, patients receiving the combined treatment reported greater relief from nasal itching, sneezing, and nasal blockage. These findings suggest selective vidian neurectomy enhances FESS effectiveness, especially for nasal itching.

Diagnosing Pediatric Anesthetic Allergy

New Protocol Accurately Diagnoses Pediatric Anesthetic Allergy

A recent study supports a diagnostic protocol for pediatric local anesthetic allergies, involving intradermal testing at a 1:10 dilution followed by subcutaneous provocation. The protocol showed high accuracy, with 12.5% of 88 children testing positive on intradermal tests and 1.1% on subcutaneous provocation.

The approach demonstrated a 99% negative predictive value for immediate-type reactions. Articaine was the most common allergen identified, and safe alternative anesthetics were recommended.

Discovered Associations in the Allergy Space

Epinephrine Tied to Greater Mortality in Pediatric Septic Shock Than Norepinephrine

A study found that norepinephrine, when used as the first vasoactive agent in pediatric septic shock, was associated with lower 30-day mortality compared to epinephrine. Despite similar major adverse kidney events (MAKE30), children on epinephrine had a greater risk of death (3.7%) than those receiving norepinephrine. These findings suggest that norepinephrine may offer a survival benefit over epinephrine in treating pediatric septic shock.

Antibiotic Use in Infants Linked to Greater Asthma, Allergy Risk

A study found frequent antibiotic use in infants < 2 years is linked to a higher risk of developing asthma, food allergies, and hay fever later in life. Early antibiotic exposure disrupts the digestive microbiome, potentially impacting immune and nervous system development, leading to allergic and behavioral conditions. The research highlighted a dose-dependent relationship between antibiotic use and these chronic conditions.

Since antibiotics are vital for treating infections, the study advises cautious use in young children to prevent long-term health consequences.