Oral Immunotherapy Promising for Children With Egg Allergy
(HealthDay News) – Oral immunotherapy represents a promising therapeutic intervention for children with egg allergy, according to a study published in the July 19 issue of the New England Journal of Medicine.
A Wesley Burks, MD, from the Duke University Medical Center in Durham, NC, and colleagues conducted a double-blind, randomized, placebo-controlled study involving 55 children (aged 5–11 years) with egg allergy who were allocated to receive oral immunotherapy (40 children) or placebo (15 children). Initial dose-escalation, build-up, and maintenance phases preceded an oral food challenge at 10 and 22 months with egg-white powder. At 24 months, children underwent an oral food challenge to test for sustained unresponsiveness, and those who passed were placed on a diet with ad libitum egg consumption.
The researchers found that, after 10 months of therapy, 55% of those who received oral immunotherapy passed the oral food challenge, compared with none who received placebo. After 22 months, desensitization was observed in 75% of children in the oral-immunotherapy group. At 24 months, 28% of the oral-immunotherapy group passed the oral food challenge and were considered to have sustained unresponsiveness. All children who had passed the 24-month oral food challenge were consuming eggs at 30 and 36 months. Small wheal diameters on skin-prick testing and increases in egg-specific immunoglobulin G4 antibody levels were the immune markers that correlated with passing the oral food challenge at 24 months.
"These results show that oral immunotherapy can desensitize a high proportion of children with egg allergy and induce sustained unresponsiveness in a clinically significant subset," the authors write.
Several authors disclosed financial ties to the pharmaceutical and nutritional industries.