Food Oral Immunotherapy (OIT)

Until relatively recently, patients diagnosed with food allergy were always told that strict avoidance was necessary, in addition to ensuring that their emergency EpiPen was routinely available in the case of a severe reaction with an accidental exposure to an allergic food. This has been termed an “avoidance management strategy” or AMS.

However, in recent years, it has become clear that we can safely and effectively induce tolerance to food allergens in food allergic patients. This is done via a very gradual introduction of the food allergen over an extended period of time, such that the body develops a protective immunologic response while not provoking a food allergy reaction.

My office is pleased to announce that we will soon begin offering food oral immunotherapy (OIT). OIT offers a significant reduction in the anxiety that surrounds a possible food allergy reaction, as well as alleviating the many practical concerns that surround school events, sleepovers, camps, and other important social events for the food allergic child.

We intend to gradually roll out this therapy, offering it first for peanut allergy only during the fall of 2016. We intend to expand to other common food allergens (tree nuts, milk, egg, wheat, soy) in early 2017.

My first priority is always the safety of the patient. There is an abundant literature that food OIT can be performed safely, but there are always risks of a reaction which cannot be eliminated. Furthermore, this therapy takes significant commitment, requiring a very long day one escalation visit (typically 6-8 hours) and either weekly or biweekly dose escalation visits (approximately 20 for peanut), each one of which will be about 1 hour.

I am the first to acknowledge that there is controversy in the professional allergist community surrounding food OIT. However, this dispute stems less from whether food OIT can be conducted safely and effectively in a private practice allergy setting (there is no doubt that it can) but rather whether there remain unanswered questions in food OIT. Again, I absolutely concede that there remain questions to which we do not have complete answers (a primary question being, How long does “sustained desensitization” last if a child stops eating a maintenance dose of the food allergen after going through an OIT protocol?).

At this time, I am confident that we are able to offer a potentially life-altering therapy for patients with serious food allergies and I’m pleased to be on the vanguard of practicing allergists to begin offering this therapy.

That said, it’s vitally important that patients and parents have a comprehensive understanding of what’s known and what remains unknown regarding OIT, and that they be fully informed of the potential benefits and risks of such a therapy.

We are taking new patient consultations at this time for peanut OIT only, with an anticipated start date of September 2016 for the first patients. The consult visit will entail a long discussion about OIT, any and all questions will be answered, other allergy conditions will be assessed, and most likely, current bloodwork will be drawn (unless bloodwork from the last 6 months is available, including peanut component testing).

An OIT candidacy visit for you or your child can be scheduled by contacting my office (contact info at upper right under the “Contact” tab). I will look forward to continuing to help usher in a new era and new hope for food allergy patients and parents!
 
 
 
     
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Chapel Hill, NC 27514
Phone: (919) 929 9612
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