Oral immunotherapy for individuals who are allergic to egg is not endorsed in American professional society guidelines, nor do they provide protocols for it.This study showed that a low-dose, pasteurized liquid egg used for oral immunotherapy had the highest success rate and low risk for reactions after initial dose escalation.Researchers suggested that the findings might help other practices adopt egg oral immunotherapy more widely to improve patient access.
For egg-allergic children, an oral immunotherapy (OIT) protocol using low-dose liquid egg to start appeared to be the most successful in inducing tolerance in the outpatient setting, according to one academic center's experience.
Compared with a protocol using either baked egg or high-dose liquid egg, OIT success was higher in those given low-dose liquid egg as indicated by 94% of patients becoming able to freely eat eggs as components of baked goods like cookies plus tolerate at least 3 g of egg on its own (17 of 18 vs 54 of 78 with the other two protocols combined, P<0.001).
Measuring success with a formal food challenge with 12 g of egg protein, the low-dose native egg protocol again came out on top, with 78% passing the test (14/18) compared with 61% (31/51) on the high-dose egg protocol and 44% (12/27) with baked egg for OIT, Antonella Cianferoni, MD, PhD, of Children's Hospital of Philadelphia, and colleagues reported in the Annals of Allergy, Asthma & Immunology.
