Recapping AAAAI 2026: Updates on Remibrutinib and Innovative Treatments for Food Allergy, Atopic Disease, Asthma

Research presented at the 2026 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting highlighted emerging therapies, evolving clinical strategies, and new insights into the management of allergic, immunologic, and respiratory diseases. The meeting included the latest evidence shaping patient care, including advances in biologic therapies, immunotherapy approaches, and novel treatment targets for conditions such as asthma, chronic urticaria, and food allergies.

Across presentations and newly published data, investigators emphasized improving disease control, expanding treatment options for patients with severe or difficult-to-treat conditions, and refining personalized approaches to therapy. Together, the research showcased at the meeting reflects a growing momentum in allergy and immunology research aimed at improving outcomes and quality of life for patients worldwide.

Updates on Remibrutinib

Remibrutinib (Rhapsido; Novartis) was FDA approved as the first oral, advanced therapy for chronic spontaneous urticaria (CSU) back in September 2025. Remibrutinib works as a Bruton’s tyrosine kinase inhibitor (BTKi), helping to inhibit the release of histamine and other proinflammatory mediators, which is the first of its kind for CSU.¹ The medication’s mechanism of action, efficacy, and safety were discussed in a presentation by Giselle Mosnaim, MD, MS, FAAAAI.

In phase 3 clinical trials, patients with symptomatic CSU after treatment with second-generation H1-antihistamines were enrolled to either receive oral remibrutinib 25 mg twice daily or placebo. At week 12, the remibrutinib group had a significantly greater decrease in the Urticaria Activity Score over 7 days (UAS7) vs placebo (least-squares mean change, −20 vs −13.8 [P < .001] in REMIX-1; and −19.4 vs −11.7 [P < .001] in REMIX-2).^2,3 Notably, a pooled analysis of the phase 3 REMIX-1/-2 studies also demonstrated that patients in the remibrutinib group noted reduction in disease activity within the first 12 hours of their dose and was sustained through day 7, as presented at the poster sessions.⁴

The approval of remibrutinib is very exciting, as the current advanced therapies for CSU are subcutaneous injections, which may not be feasible for some patients. The treatment does not require lab monitoring and is given orally twice daily, making it an easy, effective option for patients with uncontrolled CSU who have failed second-generation H1-antihistamines.¹ Pharmacists should stay up to date with formulary changes and be aware of copay card and patient assistance programs.

During one of the poster sessions, phase 2 trial data was presented on the efficacy and safety of remibrutinib for patients with immunoglobulin E-mediated peanut allergy. Remibrutinib was evaluated at 3 doses, 10, 25, or 100 mg compared with placebo. At 4 weeks, approximately 40% of patients taking 10 mg twice daily, 50% taking 25 mg twice daily, and 86.7% taking 100 mg twice daily were able to tolerate at least 600 mg of peanut protein, versus zero patients in the placebo group.^5,6 Due to these results, a phase 3 trial is planned to begin in the second half of 2026.⁷

Updates on Treatments for Food Allergies

Preliminary results of the ALLIANCE phase 1/2 clinical trial (NCT05440643) were presented at the annual meeting. This trial evaluated the safety and efficacy of a peanut sublingual immunotherapy (SLIT) tablet across pediatric and adult populations (4–65 years).^8,9

The first part of the trial, participants received 1 of 5 escalating doses daily for 2 weeks to determine the starter dose for part 2. All participants tolerated their assigned dose. No treatment-related adverse events (AEs), no systemic allergic reactions, no epinephrine administration, and no severe swelling of the mouth/throat occurred.^8,9

In part 2, participants received an open label up dosing regimen of 5 doses, each for 2 weeks daily. Importantly, in part 2, 27 of 32 participants tolerated the highest dose. Only 4 patients discontinued due to adverse effects (AEs); the most common AEs were mild to moderate oral pruritis, throat irritation, and stomach pain. There were 2 systemic allergic reactions (nonsevere; no anaphylaxis), not treated with epinephrine, and a local reaction of gastrointestinal symptoms of moderate intensity that was treated with epinephrine. No severe swelling of mouth/throat occurred, and no cases of eosinophilic esophagitis occurred.^8,9

The study is expected to be fully completed later this year. Pharmacists should be on the lookout for these results, and aware of this therapy as a possible more convenient treatment for patients in the future.

Results from the VITESSE phase 3 clinical trial (NCT05741476) were also an exciting update at the 2026 AAAAI Annual Meeting. This trial evaluated the efficacy and safety of the Viaskin Peanut patch (DBV Technologies), an epicutaneous immunotherapy containing 250 µg of peanut protein, in children aged 4 to 7 years. The study met its primary end point, demonstrating that 46.6% of treated participants were considered “responders” (defined as an increase in eliciting dose between baseline and month 12) compared with only 14.8% in the placebo group.^10-12

Safety data was favorable, with the most common AEs being mild to moderate skin irritation at the application site. The percentage of treatment related anaphylactic reactions was low at 0.5%.^11,12 Adherence rates in the treatment group were approximately 96%, indicating that this could be an easy, noninvasive option to provide to patients and their families to prevent reactions with accidental peanut exposure. The data is expected to be submitted to the FDA later this year in pursuit of FDA approval.

Importantly, stage 3 trial results of the phase 3 OUtMATCH clinical trial (NCT03881696) were also presented at the meeting. In a study of 80 participants who had completed 52 weeks of treatment of either omalizumab (Xolair; Genentech) or multifood oral immunotherapy, researchers tracked the ability to integrate 1 to 3 allergens into a standard diet. Success was measured by consistent daily consumption (at least 300 mg of the allergen) over a 12-month duration.^13-15

At 6 months, results showed that both treatments were equally effective, with over 60% of participants in both groups successfully introducing the allergic foods into their diet. Safety was similar in both groups. In the omalizumab group, 2 patients (7%) required epinephrine, and 3 patients (10%) met anaphylaxis criteria potentially related to the consumption of the allergen.^14,15

Ultimately, these findings establish omalizumab as a viable, possibly less-intensive alternative for patients seeking long-term desensitization and dietary freedom. 

A New Treatment for the Atopic March?

Exciting results from the randomized, double-blind, placebo-controlled phase 1b/2 ADORED clinical trial (NCT05003804) were presented at the conference. The trial investigated treatment with STMC-103H (Siolta Therapeutics), a novel live oral microbial product, in neonates with immediate family history of atopic disease. A total of 238 at-risk neonates (age <14 days) were randomly assigned to either receive treatment or placebo orally daily for 336 days.¹⁶

Participants who completed the full year of treatment showed an approximate 64% reduction in the risk of developing atopic dermatitis compared with placebo (23.3% vs 43.1%; OR 0.36 [90% CI 0.20–0.66]; p = .005, n = 158) on day 336. Treatment with STMC-103H also reduced the risk of physician-diagnosed food allergy by 77% (4.7% vs 16.7%; OR 0.23 [90% CI 0.09–0.63]; p = .02); however, when all participants were included in the analysis (intention to treat), the results did not reach statistical significance. There did not appear to be any significant difference in AEs between the 2 groups.^17,18

The results suggest a possible protective effect against the “atopic march” and will hopefully be further studied as the developing company intends to advance to the next steps towards future FDA approval.

Treatment With GLP-1 Receptor Agonist May Reduce Asthma Exacerbations

A cohort study evaluating the association between glucagon-like peptide-1 Receptor agonists (GLP-1 RA) and asthma exacerbations in nondiabetic patients with obesity was a highlight of the 2026 AAAAI Annual Meeting. Researchers used data from the global collaborative network in TriNetX to track asthma exacerbation rates over a 3-year period. Three groups of patients with asthma and without diabetes were evaluated: overweight (n = 710; body mass index [BMI]: 25–29.99 kg/m²); obese (n = 1515; BMI: 30–40.00 kg/m²); and morbidly obese (n = 1249; BMI: ≥40.00 kg/m²).^19,20

The overweight group experienced an approximate 14.6% reduction in asthma exacerbation risk, the obese group showed a 12.2% reduction in risk, and the morbidly obese group demonstrated a 13.3% reduction in risk; p < .0001 for all groups. Of note, patients on biologic therapy at baseline were excluded^19,20; however, these results indicate that treatment with a GLP-1 RA may help to reduce asthma exacerbations in patients with a BMI of 25 or higher. More research will be needed to see if GLP-1 RAs might be an option for asthma treatment in the future.

What Pharmacists Should Know

Overall, the 2026 AAAAI Annual Meeting featured many exciting research results. There were notably many possibly game changing research results in food allergy treatment.

Pharmacists should stay up to date on this as in the future, we may have several options to treat food allergies, including omalizumab injections, the Viaskin Peanut patch, and perhaps eventually an oral tablet, as demonstrated by the early remibrutinib results.

The results of the remibrutinib CSU clinical trials also were featured, hopefully bringing awareness to this as an excellent oral option for treatment of CSU. Pharmacists should be aware of this option and the results of the clinical trials, and advocate for those patients who do not want to receive injectable therapies.

More research will be needed on the oral microbial product STMC-103H, but this also represents an exciting advancement in the prevention of atopic diseases in the future. Pharmacists working with asthma and allergy patients should stay up to date with this as a possible therapy in the future.

REFERENCES

1. Novartis. Novartis receives FDA approval for Rhapsido® (remibrutinib), the only oral targeted BTKi treatment for chronic spontaneous urticaria (CSU). News release. February 24, 2026. Accessed March 2, 2026. https://www.novartis.com/us-en/news/media-releases/novartis-receives-fda-approval-rhapsido-remibrutinib-only-oral-targeted-btki-treatment-chronic-spontaneous-urticaria-csu

2. Ferruggia K. AAAAI: Remibrutinib emerges as first oral advanced therapy for chronic spontaneous urticaria. Pharmacy Times. February 27, 2026. Accessed March 2, 2026. https://www.pharmacytimes.com/view/aaaai-remibrutinib-emerges-as-first-oral-advanced-therapy-for-chronic-spontaneous-urticaria

3. Metz M, Giménez-Arnau AM, Hide M et al. Remibrutinib in chronic spontaneous urticaria. N Engl J Med. 2025;392(11):984-994. doi:10.1056/NEJMoa2408792

4. Windom H, Machado P, Ortmann CE, et al. Remibrutinib provides fast symptom relief within the first week of treatment in chronic spontaneous urticaria, as measured by daily urticaria activity score: pooled REMIX-1/-2 studies. J Allergy Clin Immunol. 2026;157(2 suppl):AB14. doi:10.1016/j.jaci.2025.01.228

5. Wood R, Tan R, Shah R, et al. Efficacy and safety of remibrutinib, a Bruton's tyrosine kinase inhibitor, for individuals with IgE-mediated peanut allergy. J Allergy Clin Immunol. 2026;157(2 suppl):AB190. doi:10.1016/j.jaci.2025.12.569

6. Phend C. BTK Inhibitor shows promise in peanut allergy. MedPage Today. March 1, 2026. Accessed March 2, 2026. https://www.medpagetoday.com/meetingcoverage/aaaai/120100

7. Novartis. Novartis presents Rhapsido® (remibrutinib) data at AAAAI showing potential beyond chronic spontaneous urticaria (CSU). News release. February 28, 2026. Accessed March 2, 2026. https://www.novartis.com/news/media-releases/novartis-presents-rhapsido-remibrutinib-data-aaaai-showing-potential-beyond-chronic-spontaneous-urticaria-csu

8. Kim E, Zhou S, Hargreaves K, et al. Preliminary safety and tolerability results from ALLIANCE, a phase I/II trial of a peanut sublingual immunotherapy tablet. J Allergy Clin Immunol. 2026;157(2 suppl):AB188. doi:10.1016/j.jaci.2025.12.564

9. McGovern G. ALLIANCE trial: peanut sublingual immunotherapy is well-tolerated in children with peanut allergy. Pharmacy Times. March 1, 2026. Accessed March 2, 2026. https://www.pharmacytimes.com/view/alliance-trial-peanut-sublingual-immunotherapy-is-well-tolerated-in-children-with-peanut-allergy

10. Safety and Efficacy Study of Viaskin Peanut in Peanut-allergic Children 4-7 Years of Age (VITESSE). ClinicalTrials.gov identifier: NCT05741476. Updated January 22, 2026. Accessed March 2, 2026. https://clinicaltrials.gov/study/NCT05741476

11. Fleischer D, Mack D, Wang J, et al. VITESSE phase 3 study: efficacy and safety of epicutaneous immunotherapy in peanut-allergic children 4 through 7 years of age. J Allergy Clin Immunol. 2026;157(2 suppl):AB189. doi:10.1016/j.jaci.2025.12.566

12. Phend C. Epicutaneous patch therapy shows efficacy in peanut-allergic kids. MedPage Today. March 1, 2026. Accessed March 3, 2026. https://www.medpagetoday.com/meetingcoverage/aaaai/120108

13. Omalizumab as Monotherapy and as Adjunct Therapy to Multi-Allergen OIT in Food Allergic Participants (OUtMATCH). ClinicalTrials.gov identifier: NCT03881696. Updated September 10, 2025. Accessed March 3, 2026. https://clinicaltrials.gov/study/NCT03881696

14. Chinthrajah RS, Lanser BJ, Scurlock A, et al. Evaluation of dietary consumption feasibility following treatment with multi-food oral immunotherapy or omalizumab in OUtMATCH. J Allergy Clin Immunol. 2026;157(2 suppl):AB419. doi:10.1016/j.jaci.2025.12.928

15. Phend C. Biologic on par with OIT for turning allergy-forbidden foods into everyday eats. MedPage Today. March 2, 2026. Accessed March 3, 2026. https://www.medpagetoday.com/meetingcoverage/aaaai/120115

16. Allergic Disease Onset Prevention Study (adored). ClinicalTrials.gov identifier: NCT05003804. Updated November 20, 2025. Accessed March 5, 2026. https://clinicaltrials.gov/study/NCT05003804

17. O’Sullivan M, Vickery B, Varshney P, et al. STMC-103H reduces risk of atopic dermatitis and food allergy in at-risk infants: results of the phase 1b/2 randomized, double-blind, placebo-controlled ADORED trial. J Allergy Clin Immunol. 2026;157(suppl 2):AB423. doi:10.1016/j.jaci.2025.12.938

18. McGovern G. Investigational STMC-103H may protect at-risk infants against development of atopic disease. Pharmacy Times. March 2, 2026. Accessed March 4, 2026. https://www.pharmacytimes.com/view/investigational-stmc-103h-may-protect-at-risk-infants-against-development-of-atopic-disease

19. Patel R, Beckley Z, Patchett B, et al. Associations between Glucagon-Like Peptide-1 Receptor Agonists and asthma exacerbations in non-diabetic patients with obesity: cohort study. J Allergy Clin Immunol. 2026;157(suppl 2):AB184. doi:10.1016/j.jaci.2025.12.553

20. Eslava-Kim L. GLP-1 RAs linked to reduced asthma flares in overweight nondiabetic patients. Monthly Prescribing Reference. March 3, 2026. Accessed March 4, 2026. https://www.empr.com/reports/glp-1-ras-linked-to-reduced-asthma-flares-in-overweight-nondiabetic-patients/