Oral Immunotherapy FAQs

What is Oral Immunotherapy (OIT)?

Oral immunotherapy is a desensitization treatment in which the immune system is re-trained to tolerate food proteins to which it is currently sensitized.  Food-allergic patients consume increasing quantities of the food protein through the gastrointestinal tract daily over the course of a year.  Once the maintenance dose has been achieved, and the body is desensitized to the allergen, the patient is able to consume the allergen without at reaction.

What is the Goal of OIT (How much protection does OIT give)?

The primary goal of OIT is to be able to offer the patient protection from anaphylaxis by allowing them to ingest a full serving of the allergen without any reaction.  OIT would allow patients a better quality of life by allowing them to freely eat food without worry of cross contamination of their allergen.  Some patients are able to incorporate the food allergen completely into their diet, if desired.  Clinical studies have shown that the IgE trend down, with evidence of sustained unresponsiveness, along with DNA changes.

What Foods can be done with OIT?

Any IgE-mediated food allergy can be treated with OIT.  Our office currently offers OIT for:  peanuts, tree nuts (almond, pecan, walnut, hazelnut, cashew, pistachio, brazil nut, macadamia nut), milk, and egg.  Contact our office to inquire about other foods.

Who are the best candidates for OIT?

Patients with severe, life-threatening reactions to food allergens would benefit the most from OIT.  In addition, OIT is recommend for patients who experience anxiety from food avoidance, cross contamination, and Epi-pen experiences.  OIT offers increased safety and a better quality of life.  OIT can begin for patients as early as 2-3 years old, who have the ability to communicate articulately, follow directions, and maintain quiet activity for 2 hours.

What excludes a patient from doing OIT?

Uncontrolled asthma is a contraindication of OIT because strong lung function is necessary due to increased risk of an allergic reaction during OIT.  In addition, patients with eosinophilic esophagitis (EoE) cannot undergo OIT because the inflammation of the lining of the esophagus can be worsened by the exposure of the ingested allergens.

How long does the process take?

Patients consume their dose once a day, and updose every 10-14 days.  It normally takes between 20-25 updoses (about 40-50 weeks) to reach maintenance.  However, if a patient requests, Dr. Agrawal is open to twice a day dosing, with updoses every week.

How long does each office visit take?

The first day of OIT consists of a 4-6 hour day, during which the allergen is consumed in gradual increasing amounts during that time.  A typical updose visit will take approximately an hour.

How often do you take the doses?

Doses are consumed once a day, with updoses every 10-14 days.  For patients undergoing multiple-nut OIT, it is preferable to do twice a day dosing, with updoses every week.

What is the Observation Period?

A 1-hour observation period is required to ensure the dose is tolerated.  A second hour of low activity should also be observed.

Are there any side effects to doing OIT?

Mild reactions during food desensitization are not uncommon, and may include itching of the throat and mouth, abdominal pain, nausea, vomiting, reflux, or gas.  Some side effects are self-limited, and others are managed with dietary modification, antacid medication, antihistamines, or dosing adjustments.

 

Links/Articles

www.oit101.org
www.oitcenter.com

Facebook Pages Related to OIT/Food Allergies

OIT101 Facebook Page

Private Practice OIT Facebook Page

Dr. Agrawal OIT Group

Peanut Anaphylaxis Cure