Is there a role for omalizumab in a patient who is on VIT but still experiences anaphylaxis to stinging insects?  

The Practice Parameters suggest that the dose should be doubled in such patients for improved protection, so omalizumab may not be the first step. Also, the frequency of the maintenance dose could be increased (e.g. every 2-3 weeks). Although there may be a role for omalizumab (off-label) to reduce...