Omalizumab in Severe Asthmatics With Food Allergy

Inclusion Criteria: * Age 6 - 18 years * Severe persistent allergic asthma according to the GINA guidelines * Sensitized to a perennial aeroallergen, as witnessed by positive skin test and/or in vitro reactivity * Symptoms inadequately controlled with inhaled corticosteroids + another medication, as witnessed by an ACT ≤ 19 * On treatment with high dose inhaled corticosteroids + another medication. Threshold dose for inhaled corticosteroids set at 400 mcg/day budesonide (or equivalent doses) for children \< 12 years, at 800 mcg/day for older patients. * Immediate food allergy with anaphylactic symptoms within 1hr. of ingestion of milk, egg, wheat, peanut, hazelnut, and/or codfish. * Total IgE \< 70 and \>1,500 kU/L at baseline * Sensitivity to food allergen documented by a positive skin prick test result and/or allergen-specific IgE level, with 0.35 kU/L as a lower limit of eligibility * Positive OFC within the past 12 months, with minimal or no reactions to the placebo challenge. * Trained on the proper use of epinephrine * In case of female subjects of child-bearing potential, negative human chorionic gonadotropin blood sample for pregnancy testing * No known contraindications to oral immunotherapy with food protein or Omalizumab * Parent/legal guardian written informed consent Exclusion Criteria: * Total IgE at screening \> 70 or ≤ 2,500 kUI/L * allergy to food(s) not investigated in this study * Immune deficiency * Previous reaction to Omalizumab * Previous organ transplantation * Use of monoclonal antibodies in the previous 6 months * Subjects with gastrointestinal or gastroesophageal disease, chronic infections, scleroderma, hepatic and gallbladder disease, chronic non-allergic pulmonary disease. * Subjects who have received an experimental drug in the last 30 days prior to admission into this study or who plan to use an experimental drug during the study * Pregnant or breast-feeding females. * Subjects with food protein induced enterocolitis syndrome (FPIES) * Subjects is on a build-up phase of standard subcutaneous immunotherapy for inhalant allergens (may be enrolled on maintenance dose) * Inability to discontinue antihistamines for 5 half-lives prior to routine study tests (OFC) * Subjects with weight-IgE combination yielding a dose requirement greater than 600 mg according to the EMA schedule for Omalizumab * Systemic steroids oral, IM, or IV for indications other than asthma for more than 3 weeks in the past 6 months.