Thank you for your inquiry.
Unfortunately, I cannot give you any evidence-based opinion as to the safety of the immunotherapy regimen you are proposing. This is because I know of no study that has investigated this regimen and compared its safety to more orthodox programs of treatment. However, my guess is that it would be as safe as standard therapy regimens, but in this situation, the only opinion is hypothetical.
However, if you are worried about the safety of immunotherapy, there are other options for you. You mentioned that you had planned to stop omalizumab when you reached the maintenance dose. This certainly is a feasible strategy, but I would mention to you that these two treatments are not interchangeable. Omalizumab and immunotherapy act through different mechanisms, and immunotherapy may not be an adequate substitute for omalizumab in your situation. For example, omalizumab has been shown to be effective not only in allergic but also in nonallergic asthma (1-3). Thus, you cannot be sure that immunotherapy will substitute for omalizumab in your patient, and the question then becomes, since she is under control, and since you are worried about the safety of an unorthodox immunotherapy regimen, an alternative would be to simply continue her on omalizumab without the addition of immunotherapy.
There is of course no "right" or "wrong" answer to this question, but it is something that you could consider as another strategy which would alleviate concern over the unorthodox regimen of immunotherapy.
Thank you again for your inquiry and we hope this response is helpful to you.
1. J Allergy Clin Immunol 2013; 131(1):110-116.
2. Chest 2011; 139(1):8-10.
3. Thorax 2014; 69(1):94-96.
Phil Lieberman, M.D.