Bridging innovation and risk: the missing role of validated risk-stratification in IgE-mediated food allergy management.

Over the last decade, the prevalence of IgE-mediated food allergies has increased, alongside therapeutic innovations such as oral immunotherapy (OIT), omalizumab, combination approaches, intranasal epinephrine, and emerging biomarker-guided strategies. This mini review synthesizes evidence published between 2019 and 2025 and evaluates how these advances intersect with persistent safety and clinical decision-making challenges. Although these therapies demonstrate promising efficacy, validated risk-stratification tools capable of guiding individual treatment selection are lacking. The proposed conceptual framework illustrates how patient characteristics, biomarkers, and treatment-specific risks may ultimately support individualized therapeutic decision-making.