Oral immunotherapy for food allergy: Translation from studies to clinical practice?

Guillaume Pouessel; Guillaume Lezmi

doi:10.1016/j.waojou.2023.100747

Oral immunotherapy for food allergy: Translation from studies to clinical practice?

World Allergy Organ J. 2023 Feb 3;16(2):100747. doi: 10.1016/j.waojou.2023.100747. eCollection 2023 Feb.

Authors

Guillaume Pouessel^{1

2}, Guillaume Lezmi³

Affiliations

¹ Department of Paediatrics, CH Roubaix 59056, France.
² Paediatric Pneumology and Allergology Unit, CHRU Lille, 59037, France.
³ Paediatric Pneumology and Allergology Unit, Children's Hospital Necker, Paris, 75013, France.

Abstract

Oral immunotherapy (OIT) is now recognized as an alternative active treatment to strict food avoidance in certain patients with IgE-mediated food allergy. Studies have confirmed the efficacy of OIT to desensitize children with allergy to cow's milk, eggs, and peanuts. The benefits, risks, and constraints of OIT are becoming increasingly well understood. However, there is no consensual criteria to select patients to whom OIT could be proposed, and many issues remain to address including the definitions of desensitization and long-term efficacy, the assessment of patient's experience in real life, the optimization of buildup and maintenance protocols, and the utility of multiple food OIT. The recent authorization by medical agency concerning the first medicine for peanut OIT is a step forward towards higher standardization in the practice of OIT. This article summarizes in comprehensive narrative format data on efficacy, tolerance, impact on quality of life and adverse effects of OIT and discuss elements to consider in clinical practice before starting OIT.

Keywords: Allergy; Anaphylaxis; Desensitization; Food; Oral immunotherapy; Shared decision..

Publication types

Review