Q:

10/31/2013
I am now hearing about private practice allergy groups using oral desensitization to peanut, milk, and eggs. I am reading both pro/con about using food desensitization protocols for routine practice and I would like your opinion on this subject as an expert in anaphylaxis.

A:

Thank you for your inquiry.

Below you will see three resources all of which are readily available to you that will give you what I feel is the appropriate answer to your question. One is an article from The Journal of Allergy and Clinical Immunology (JACI), and another from JACI “In Practice.” The third is a You Tube link of an interview of Dr. Wesley Burks by Dr. Scott Sicherer.

1. J Allergy Clin Immunol. Author manuscript; available in PMC 2011 July 1.
Published in final edited form as: J Allergy Clin Immunol. 2010 July; 126(1): 31–32.
doi: 10.1016/j.jaci.2010.05.012
PMCID: PMC2904630
NIHMSID: NIHMS215335 Peanut Oral Immunotherapy (OIT) is Not Ready for Clinical Use.
Ananth Thyagarajan, MD, Pooja Varshney, MD, Stacie M. Jones, MD, Scott Sicherer, MD, Robert Wood, MD, Brian P. Vickery, MD, Hugh Sampson, MD, and A. Wesley Burks, MD

2. The Journal of Allergy and Clinical Immunology: In Practice
Volume 1, Issue 1 , Pages 15-21, January 2013 Peanut Oral Immunotherapy: Is It Ready for Clinical Practice? Hugh A. Sampson, MD
The prevalence of peanut allergy in the United States and other Westernized countries has tripled in the past 15 years, now affecting more than 1% of the population. Strict peanut avoidance is the current standard of care. In the past decade, a number of small, largely uncontrolled clinical trials have suggested that oral immunotherapy (OIT) can effectively desensitize most children with peanut allergy. Some in the allergy community now feel that OIT is ready for clinical practice. In this review, the evidence base in the medical literature is examined. Although peanut OIT shows promise, the evidence currently available on its effectiveness, risk benefit, and potential long-term consequences is insufficient to support its use in clinical practice. Appropriately designed, prospective clinical trials are urgently needed to determine whether OIT is a safe, effective form of therapy for food allergy.

3. Sublingual immunotherapy for peanut allergy" with Wesley Burks
Scott Sicherer, MD talks with Wesley Burks, MD about Dr. Burks's article "Sublingual immunotherapy for peanut allergy: A randomized, double-blind, placebo-controlled multicenter trial " in the January…
Interview of Dr Burkes by Dr Sicherer

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology