Oral Immunotherapy (OIT) is increasingly becoming a treatment method for desensitizing children from their allergens. But what about adults?
With data regarding the success rates of adult OIT lacking, researchers from the Shamir Medical Center Allergy Clinic in Zerifin, Israel, and the Sackler School of Medicine, Tel Aviv University set about to find answers. Their study was recently published in the journal Allergy.
The team retrospectively analyzed the medical records of patients with food allergy 17 years and older who completed OIT treatment between April 2010 and December 2020 at Shamir Medical Center. They compared the results with those of children between the ages of 4 and 10 years and adolescents between the ages of 11 and 17 during the same time period.
96 adults with a median age of 22.3 years who underwent OIT were identified with the following distribution:
- 53 for milk
- 18 for peanuts
- 13 for tree nuts
- 7 for sesame
- 5 for eggs
Their results were analyzed and compared with those of 1299 children and 309 adolescents.
Despite adults experiencing more adverse reactions requiring epinephrine during in-clinic up-dosing (49% vs 15.9% and 26.5% for children and adolescents) and during at-home treatment (22.9% vs. 12.4% for children, and 17.5% for adolescents).
Most adults were able to achieve full desensitization (61.5%) but the rates were significantly lower than those for children (73.4%).
Unfortunately, a significantly higher ratio of adults (28.3%) receiving OIT for milk failed treatment versus children (14.3%) and adolescents (14.1%). Failure rates for adults undergoing OIT for the other allergens were relatively low and comparable to those of children and adolescents.
Lead author Na’ama Epstein-Rigbi, MD, summed up their conclusions to Medscape Medical News:
Our experience from over a decade of oral immunotherapy, treating many adults, shows favorable outcome and safety profile for non-milk allergens. As for milk oral immunotherapy, this is a more difficult allergen to treat in all populations. In adults, success rates are significantly lower, with a profound amount of severe reactions.
