ORAL IMMUNOTHERAPY
Over the past few decades, the incidence of allergic disease has increased with rates of food allergy growing by two – three fold.
Oral immunotherapy (OIT) for food is a process in which a food allergic patient is given very small amounts of the food that they are allergic to, such as peanut or milk. Gradually over a period of 6 – 8 months, the amount of food ingested patient is increased. The goal of OIT is long-term risk mitigation.
OIT is an uninsured service and is not covered through OHIP.
Oral immunotherapy (OIT) is the gradually increasing exposure of a food allergen (i.e. peanut) to a person with that particular IgE-mediated food allergy. These exposures are progressively increased over time during clinic visits and daily exposure is maintained, often for life. The goal of OIT is to mitigate potential allergen exposures that may occur in real life.
There is limited data on the long-term tolerance associated with this type of therapy; thus, if OIT is discontinued, the patient will very likely return to their initial state of allergy as though they had never undergone this therapy. While some very young children may experience clinical remission, OIT is considered a lifelong therapy for most patients.
This process was first described approximately 100 years ago and it has been rigorously evaluated over the past decades. Multiple randomized, controlled and blinded trials have been performed and published over the past decade. The Phase 3 trials demonstrated that patients who had completed OIT could safely ingest significant amounts of peanut with little to no reaction. In addition, these trials also showed significantly reduced epinephrine (EpiPen) use in the setting of an allergic reaction, and reactions were typically milder than in those patients that had not undergone OIT. As a result, this medication has been approved by the FDA and EMA as a risk mitigation strategy.
Importantly, for many of our families, quality of life can improve significantly. This improvement has been demonstrated in multiple studies evaluating the psychosocial burden of food allergy and OIT.
Specialist allergy clinics offer this therapy across North America and in other countries. The Canadian Society of Allergy and Clinical Immunology and the European Academy of Allergy and Clinical Immunology have written consensus guidelines suggesting OIT as an effective treatment option for the management of food allergy.
Dr. Mack has recently advanced the field of OIT as the co-editor of the first North American OIT manual featuring contributions from world-wide leaders in the food allergy field.
Provincial health plans do not typically cover this therapy, and in Ontario OIT is considered an uninsured service.
Halton Pediatric Allergy currently offers an extensive and comprehensive OIT treatment program and we have published our approach to OIT in peer-reviewed journals. Over our many years of performing OIT, we have developed a very structured process that involves extensive education, counselling and support to maintain patient safety.
We are happy to discuss this process with you in detail. Your first step is to obtain a referral from your doctor to our clinic.
INTERESTED IN OIT?
We recommend watching the following doumentary...
LEARN THE BASICS...
Dr. Mack and Dr. Hanna talk about the basics of OIT!
What is Oral Immunotherapy?
Dr. Mack is the co-editor of the first North American OIT Manual featuring practical and high quality chapters by the leading experts in the field of food allergy.
To learn more, click here!
