Food Allergy Successes: 300 OIT Graduates and Counting!
Reaching the 300 mark for patients who have completed the Oral Immunotherapy (OIT) program is a reason to celebrate for doctors, patients and their families. After all, improving the quality of life for children with food allergies is a parent’s greatest hope and a doctor’s greatest goal.
With OIT, 300 children (and counting) now experience a transformed quality of life, free from the worry of food allergies. Graduates of the APNT Oral Immunotherapy Program have lots to say about how OIT changed their lives.
OIT, a proven desensitization process, can provide a long-term solution for peanut, milk, egg, tree nut and wheat allergic patients. It usually takes less than 6 months, and at the end of the program, most patients with these food allergies are free to eat the foods they want, whenever they want.
Parents say that after OIT their children are less anxious about food and going to new places, less concerned that they will have a reaction, have less physical and emotional stress, enjoy eating in restaurants more, and feel safer when going on vacation or to summer camp. The children also feel more included in activities at school involving food and participate more in social interactions and events.
Who can be treated?
If the patient has a confirmed food allergy based on a recent history and a significantly positive food allergy blood test or skin test, he or she is eligible for OIT. If their diagnosis is less certain, that is, there has been some problem or a positive test in the past, but no recent reaction, additional testing is done to confirm the food allergy.
Confirmatory testing by blood test and skin test may be sufficient but, often an oral food challenge or OFC is performed. This is the gold standard for food allergy testing and involves carefully giving increasing amounts of the suspect food while carefully watching for signs of a reaction.
If there are any symptoms, such as itchy mouth or hives, the OFC is positive confirmation of the food allergy. If a meal-sized portion (e.g., 8 ounces of milk or a whole egg) is eaten with no problem, the food allergy has been disproved. All patients with confirmed food allergies are eligible for treatment.
How is the treatment performed?
Before starting OIT, parent(s) and child attend at least two office visits to be sure that all other allergy-related problems have been identified and controlled. At these visits, OIT is explained and questions answered. All patients must be seen within the month before beginning OIT treatment. They also have the option to speak with or meet other parents of children who have completed the treatment.
Every child is different, so each treatment is individualized. Children are shown how the doses are mixed and shown big board with photos of OIT graduates to help the children realize that once the treatment is successful they can attend birthday parties, campouts and do more things with their friends without food allergy worries.
The protocol for treatment starts with a powdered form of food diluted in water mixed with Kool-Aid flavoring that is then administered orally with a syringe. For liquid foods such as milk, no powder is used. The next step is to progress to a powder form of the food and final stage is solid food, such as a whole peanut, egg or organic whole milk.
Patients are allowed to progress at their own pace, but a minimum of 5 days of twice daily dosing at home is required for each dose increase. The average length of time required for the patient to reach his/her target maintenance dose is 26 weeks. However, some may take longer. If a child experiences allergic symptoms, the dose is reduced by 50% and maintained there until the dose is tolerated.
Once the target maintenance dose is reached, a full serving of that food is eaten on a daily basis in order to maintain the desensitized state. After three years of maintenance therapy, those patients who have achieved a 95% reduction in food specific IgE antibody from baseline may be eligible for less frequent maintenance dosing.
More than 80% of our patients who have been treated with OIT can now safely consume foods that once threatened their health.