Multi-food Oral Immunotherapy Found to Be Safe and Effective

Combining multiple food allergies into one oral immunotherapy course can save time without raising risk, according to research that was scheduled to be presented at the 2020 AAAAI Annual Meeting.

MILWAUKEE, WI – Combining multiple food allergies into a single oral immunotherapy course is as safe and effective as single food immunotherapy, according to research scheduled for presentation at the 2020 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting before it was cancelled due to the situation with coronavirus disease 2019 (COVID-19).

A retrospective review was used to complete the study, looking at patients who started peanut oral immunotherapy (OIT) from April 2014 through September 2018 and patients undergoing multi-food OIT from February 2015 through September 2018. Diagnostic allergy testing was encouraged every year and reactions requiring epinephrine were recorded.

Multi-food patients were treated with an average of 2.4 foods (with individual options ranging from two to four foods in one OIT course). Patients on both forms of therapy were placed on a dosing schedule with the eventual goal of reaching maintenance dosing. According to the study, 85% of peanut OIT patients reached their maintenance dose compared to 80% of those on multi-food OIT. The median amount of time it took to reach the maintenance dose was 245 days for peanut OIT and 231 days for multi-food OIT patients.

“What we discovered is that instead of cycling through multiple six to 10 month single food courses, we can safely combine multiple foods into one OIT course,” said Hugh H. Windom, MD, FAAAAI. “This gives patients with multiple food allergies more options when it comes to treatment plans.”

Epinephrine was used in 13% of patients undergoing peanut OIT and 8% of multi-food OIT patients during the first year of treatment. This is consistent with published reports, and there were no reports of severe anaphylaxis. The most common reason for stopping OIT in both groups was non-compliance and delayed gastrointestinal symptoms. This further indicates that overall, there were little differences in effectiveness and safety when comparing single food OIT to multi-food OIT.

Visit aaaai.org to learn more about OIT. This research was published in an online supplement to The Journal of Allergy and Clinical Immunology.

The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has over 7,000 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.