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Food Oral Immunotherapy

For decades there were few options for patients concerning treating food allergies other than allergen avoidance and carrying an epinephrine auto-injector for treatment of allergic reactions related to accidental exposure. Recently, there have been breakthroughs in therapies in the form of oral immunotherapy (OIT) that may potentially change one’s sensitivity to food allergen.

What is OIT?

OIT is a treatment where patients undergo desensitization to food allergens under physician supervision. Over a period of months, patients may be able to tolerate varying amounts of the food allergen. This may help mitigate severe allergic reactions related to accidental exposure. Historically, this therapy has been more widely available in European countries as well as Japan, but more recently OIT has gained traction in the United States with the first oral immunotherapy protocol for peanut, Palforzia, approved by the FDA in January 2020. Ongoing studies do suggest the theory behind OIT is also applicable for other food allergens although OIT for other foods is not FDA approved yet.

What does OIT involve?

The process of OIT usually involves an initial challenge where patients ingest doses of the food in a monitored setting. This is followed by visits that may range between every 1-3 weeks where patients ingest a dose in the clinic and are monitored for any symptoms. If patients tolerate that dose, they will continue that dose for 1-3 weeks before increasing the dose during the next office visit. The process of building up to the maintenance dose may take 5-6 months.

What are the risks of OIT?

There are risks with this treatment which does include severe allergic reactions. Contraindications for this therapy include uncontrolled asthma and an allergic gastrointestinal disease called eosinophilic esophagitis. Patients who have a difficult time remembering to take doses also are not the best candidates for this therapy as forgetting to take doses can lead to loss of tolerance.

Overall, OIT aIlows patients and their families to take better control of their food allergies and may help prevent serious life threatening allergic reactions and increase one’s quality of life. For more information, please call our office and schedule a visit with one of our allergists.