Oral Immunotherapy For Food Allergy (OIT) Effectively Desensitizes Most Infants and Young Children

Abstract

Previous reports of OIT demonstrate a desensitization rate of ;80%. Between 07/01/08 and 11/14/16, we treated 527 food allergic patients with OIT, 99% of whom were >5yo. Based on a report of successful peanut OIT in younger children, we began offering OIT to food allergic patients ages 9-36mo. We contrast the outcomes of contemporaneously treated patients <36mo and >36mo. METHODS: Retrospective record review of patients receiving OIT approved by the North Texas IRB. OIT was administered according to modifications of previously reported protocols. RESULTS: Between 11/14/16 and 6/30/19, a total of 335 children (61 <36mo and 274 >36mo) began OIT. Children <36mo were treated with one or more of seven different foods (peanut, cashew, walnut, sesame seed, egg, milk, and wheat) and >36mo with 18 different foods. At the end of the study period, 185/222 (83%) patients (excluding those escalating OIT or who transferred care), comprising 37/41 (90%) of <36mo and 148/181 (82%) of >36mo, had successfully completed OIT escalation. Eighteen patients <36mo and 78 patients >36mo were still escalating OIT. Four of the 41 (10%) patients <36mo and 33/181 (18%) patients >36mo had discontinued treatment. CONCLUSIONS: Patients >9mo may be desensitized to a variety of foods and may be treated with more than one food at a time. Young patients appear to demonstrate a higher desensitization rate than older patients. Additional studies of OIT in infants and toddlers will expand the scope of this beneficial therapy.