SINGLE VERSUS MULTI-ALLERGEN ORAL IMMUNOTHERAPY FOR TREATMENT OF FOOD ALLERGY: A RETROSPECTIVE COHORT STUDY

Abstract

<h3>Introduction</h3> With 40% of food-allergic children in the US being allergic to more than one food, more data on the safety and efficacy of multi-allergen oral immunotherapy (treating multiple allergens concurrently) will better inform clinician practice. <h3>Methods</h3> This retrospective study compares the safety and efficacy of multi-allergen versus single allergen oral immunotherapy (OIT) in two pediatric cohorts (single allergen n=169, multi-allergen n=147). Pearson Chi-square tests compared OIT completion rates (efficacy endpoint) and epinephrine use (safety endpoint). Multiple logistic regression models analyzed the difference between these endpoints while controlling for demographic differences between the cohorts. <h3>Results</h3> There was no statistical difference in OIT completion rates between the cohorts (85.2% single allergen vs 80.3% multi-allergen, p=0.245). There was a statistical difference in epinephrine use rates between cohorts (6.5% single vs 15.7% multi, p=0.009). More patients in the multi-allergen group had multiple food allergies (p=<0.001), asthma (p=0.043), allergic rhinitis (p=0.012), a prior reaction to the OIT treatment food (p=0.037), and a higher mean baseline allergen specific IgE (p=0.003). When analyzing OIT completion and epinephrine use endpoints while controlling for these differences using a multiple logistic regression model, neither OIT completion (odds ratio of 0.56, 95% confidence interval 0.23 – 1.37, p=0.205) nor epinephrine use (odds ratio of 1.63, 95% confidence interval 0.55 – 4.82, p=0.379) resulted in statistically significant differences between each group. <h3>Conclusion</h3> Multi-allergen OIT is as effective as single allergen OIT, however multi-allergen OIT may result in increased treatment-related epinephrine use, making it less safe than single allergen treatment.