Almost two thirds of adults completing an oral immunotherapy (OIT) regimen for milk, peanut, sesame, egg, or tree nuts achieved full desensitization in the largest adult OIT cohort to date, researchers from the Shamir Medical Center Allergy Clinic in Zerifin, Israel and the Sackler School of Medicine, Tel Aviv University, reported in a retrospective review published recently in the journal Allergy.
"Our experience from over a decade of oral immunotherapy, treating many adults, shows favorable outcome and safety profile for non-milk allergens," lead author Na'ama Epstein-Rigbi, MD, told Medscape Medical News, adding, "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."
In the study, a total of 93 adults, median age 23 years, were treated between between April 2010 and December 2020, and compared to 1299 children and 309 adolescents treated during the same period.
The OIT program at Shamir Medical Center is ambulatory and begins with a 3-4 day dose-escalation phase in which the single highest tolerated dose (SHTD) is determined for each patient. This dose is then consumed once daily at home for 24 days, with further up-dosing and home treatment phases in which the dose can be escalated up to fourfold.
