Oral Immunotherapy May Eliminate Egg Allergy

A new study showed that 28% of children with egg allergy who were given oral immunotherapy with gradually increased amounts of egg protein had sustained unresponsiveness at 24 months, after 22 months of treatment. 

In a double-blind, randomized, placebo-controlled trial, A. Wesley Burks, MD, of the University of North Carolina at Chapel Hill, and colleagues analyzed the effects of oral immunotherapy in 55 children aged 5 to 11 years with egg allergy. Of the 55, 15 were given placebo, while the remaining 40 were assigned gradually increasing amounts of egg-white powder. 

The children were given an oral food challenge with egg-white powder at 10 months and 22 months and with egg-white powder and a cooked egg at 24 months. After 10 months of immunotherapy, 55% of participants were able to tolerate 5 grams of egg white powder. None of the children in the placebo group showed any change in symptoms. 

At 22 months, 75% of participants receiving immunotherapy tolerated 10 grams of egg white powder and were considered to be desensitized. Desensitized children then discontinued immunotherapy and avoided all egg products for 4 to 6 weeks. At 24 months, 28% of those in the immunotherapy group had sustained unresponsiveness.   

At 36 months, 100% of the children in the immunotherapy group could eat eggs with no adverse effects.

Dr Burks cautioned against the use of oral immunotherapy at present, saying "This is a treatment that we think is safe, and we think might work, but it is not ready to be put into practice. It sounds somewhat simple, taking small doses of egg in larger and larger quantities, but it is not something to be done at home or in the office."

"For oral immunotherapy to be recommended as a standard of care," researchers concluded, "it will be important to better define the risks of oral immunotherapy versus allergen avoidance, determine the dosing regimens with the most favorable outcomes, identify patients who are most likely to benefit from oral immunotherapy, and develop postdesensitization strategies that promote long-term immune tolerance."

-Michael Potts