Food oral immunotherapy is superior to food avoidance-PRO

Abstract

Over the last decade much attention has focused on the possibility of using oral immunotherapy (OIT) as a therapeutic approach for treatment of immunoglobulin (Ig) E-mediated food allergies, a disease without a Food and Drug Administration (FDA)–approved disease-modifying therapy. Peanut allergy has been a particular concern because of its persistent nature and association with potentially life-threatening reactions. The OIT literature has been criticized for heterogeneity in trial design with disparities in identification of allergic individuals by double blind placebo-controlled food challenges, differences in desensitization approaches and maintenance doses of allergen, absence of a standardized product, inconsistency in the primary endpoint (eg, desensitization vs sustained unresponsiveness (SU)), a paucity of data on long-term effects on quality of life (QOL) and sustainability of therapy, and unproven benefits of therapeutic intervention over avoidance. In 2014, Wood and Sampson 1 Wood R.A. Sampson H.A. Oral immunotherapy for the treatment of peanut allergy: is it ready for prime time?. J Allergy Clin Immunol Pract. 2014; 2: 97-98 Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar identified many of these factors in their editorial piece in response to whether OIT was ready for clinical practice and argued that peanut OIT existed in a state of equipoise without clear evidence that the benefits of therapeutic intervention with OIT outweighed the burden of avoidance of allergen. 1 Wood R.A. Sampson H.A. Oral immunotherapy for the treatment of peanut allergy: is it ready for prime time?. J Allergy Clin Immunol Pract. 2014; 2: 97-98 Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar Food-for-thoughtAnnals of Allergy, Asthma & ImmunologyVol. 122Issue 6PreviewThis year's Food Allergy theme puts a hefty portion of food-for-thought on your plate! We bring you important updates on the clinically relevant sizzling hot topics in food allergy, spanning prevention, diagnosis, and management of IgE and non-IgE-mediated food allergic disorders. For the first time, we are show-casing a series of pro and con debates presenting opposing views and welcome your feedback whether you enjoy reading such exchanges of opinions among the experts. Full-Text PDF Pro-Con DebateAnnals of Allergy, Asthma & ImmunologyVol. 122Issue 6PreviewIn this month's issue of the Annals of Allergy, Asthma and Immunology, we are kicking off a new feature that we hope will be an exciting addition to the spectrum of information available to our readers. This will be based on the extremely popular “Pro-Con Debates” that have been featured at many annual meetings of the College. The structure of this feature is to address a topic in allergy-immunology which may be controversial, have multiple schools of thought, and/or have little hard data but still be important to our practices so that hearing contrasting opinions can be educational and, hopefully, provocative to have the reader think and read more on the subject. Full-Text PDF