Oral Immunotherapy for Food Allergies

Oral Immunotherapy for Food Allergies Feature Image
April 22, 2020

What Is Oral Immunotherapy?

Oral immunotherapy (OIT) refers to the medically supervised therapy of feeding an allergic individual an increasing amount of an allergen. The goal is to increase the threshold that triggers a reaction. OIT protocols include 2 distinct stages: an induction phase (progressive increases of threshold doses up to target dose) and a maintenance phase. When the full dose has been reached, your allergist will determine how often to continue the treatment if necessary. 

Oral immunotherapy has been used for young children with cow’s milk allergy and peanut allergy. Several studies show OIT to be effective for most patients. During this immunotherapy study, few patients (7%) developed more than 3 adverse reaction episodes during the maintenance phase. However, it’s important to note that you should continue to avoid the foods you are allergic to.

Is Oral Immunotherapy Safe?

Oral immunotherapy has been considered investigational by professional allergists. While many professionals recognize OIT as a reasonably safe treatment option for severe and long-lasting food allergies, it may not be safe for everyone. The treatment comes with many side effects including oral itching, rashes, hives, swelling, wheezing, and anaphylaxis. Anaphylaxis from food allergies can lead to other health complications including death. 

Because of the risk, patients should not attempt OIT without physician approval. A Board Certified Allergist can determine if oral immunotherapy is an option for you, though OIT is not offered by all allergists. Only a small number of allergists around the country offer OIT as a service in their offices. Many allergists do not want to take the risk of offering treatments not approved by the FDA. 

Is OIT FDA Approved?

The only FDA approved OIT is PALFORZIA for peanut allergy. PALFORZIA is approved for use in patients with a confirmed diagnosis of peanut allergy in patients aged 4 to 17. The FDA now requires the submission of a Risk Evaluation and Mitigation Strategy (REMS) for review and approval of oral immunotherapy. Both the physician and patient must be enrolled in the REMS to begin treatment. Contact one of our food allergy specialists for more information on PALFORZIA and its availability.

What Is the Best Treatment for Food Allergies?

The best treatment for food allergies is still avoidance. However, if this is not possible, be sure to carry your epinephrine auto-injector at all times. Epinephrine is the only treatment for anaphylaxis. Your NYC allergist can prescribe this medication for you and train you on how to administer it. Book an appointment at NY Allergy & Sinus Centers for your epinephrine auto-injector and other allergy medications.

Meet the Physician Collaborator

Dr. Morris Nejat is a physician specializing in Adult and Pediatric Allergy and Immunology. He is also the owner and Chief Medical Officer of NY Allergy & Sinus Centers. He received his Bachelor’s degree in zoology from Drew University before completing medical school at New Jersey Medical School. He accomplished his residency in pediatrics at North Shore University Hospital-Cornell University Medical Center. Dr. Nejat also completed a fellowship at St-Lukes Roosevelt Hospital-Columbia University College of Physicians and Surgeons. Dr. Nejat sees common cases of allergy and sinus issues with congestion and chronic cough. He is board-certified with the American Board of Pediatrics.