Allergy Affiliates has an active, large and growing OIT program. Oral immunotherapy is the only treatment for anaphylactic food allergies. We are treating children with peanut, tree nut, milk, egg and sesame allergies. Contact our office if you would like a consultation.
Oral immunotherapy, or OIT, is a proactive treatment for food allergy that trains the immune system to tolerate a food and allows the patient to eat the food without an allergic reaction.
At the first appointment, the patient is given an extremely small amount of the food and observed in the office for an hour to be sure it is tolerated. This dose is then given daily at home and increased every two weeks at an “updose” visit in our office. Within a year or less the patient will usually tolerate the equivalent of one or two peanuts or tree nuts, the amount being different for other food allergens such as egg or milk. Skin and blood tests will then be repeated to determine if the food sensitivity has decreased.
The goal is to decrease the patient’s sensitivity to the food. OIT can reduce the risk of reactions due to cross-contamination by 95 percent. Some patient will eventually be able to consume the food in normal serving amounts without any reaction, but need to remain on a daily maintenance dose so that the desensitization is not lost. It is not yet known whether OIT can be a cure, and studies are ongoing.
Most of the studies have been done with peanut, but OIT can also be done for tree nuts, milk, egg, wheat and sesame. If the patient has more than one food allergy two or more foods can be treated at a time.
Peanut, milk and egg OIT have been shown to desensitize 60 to 80% of patients. In a recent study with a commercial peanut product in patients 4 to 17 years of age, 75% of patients could eat two peanuts by the end of a year.
Reactions during OIT can occur but they are mostly mild, consisting of stomach upset or mild hives in our experience. However, more serious reactions including anaphylaxis can potentially occur. Any updose is always performed in the office with observation for at least an hour. All medications are readily available to treat any reaction. Reactions could occur at home as well, and parents must be familiar with their anaphylaxis plan. Our updosing schedule is intentionally very gradual and is meant to minimize the risk of reactions.
Most insurances cover OIT. Contact our business office if you have questions.
Avoidance of the food allergen is still the standard of care. Most allergists do not perform OIT although there may be more adoption of the treatment now that the FDA has approved a commercial peanut OIT product. The downside of not doing anything, however, is that peanut and nut allergies tend to worsen spontaneously over time, so that a mild to moderate allergy may become severe. We will always discuss the pros and cons of OIT with the family.
Our young son is being treated by Dr. Ho with OIT for peanut allergy. Our son looks forward to his appointments and we always leave feeling confident and informed. Dr. Ho’s staff is warm and courteous. Although the risk of an allergic reaction is never far from our minds, our fears are mitigated by Dr. Ho’s proactive, personalized therapy.
Mark from Toms River
Dr. Ho is one of a kind. He’s the reason why my daughter, who used to be anaphylactic to peanuts/tree nuts, can now consume these allergens without any major concern. We went to see him when she was just 11 months old and he informed us of the option to start her on oral immunotherapy treatments, which essentially involves slowly giving increasing doses of the allergen. I know many other allergists are not interested in pursuing this option due to a lack of familiarity or risk of liability. He is very detail oriented, proactive, and has a true interest in his patients. We have since moved out of state and can’t find an allergist who even comes close to him.
We have been taking our son to Dr. Ho for about 2 years now to treat his tree nut allergy. We have been ever so slowly introducing micro doses of tree nuts to my son in a controlled environment at the doctor’s office and then continuing at home in between visits. This Oral Immunotherapy (OIT) has made it possible for my son to ingest small amounts of his allergen without a reaction! I am no longer worried about him eating foods that were made in the same facility that handles tree nuts. We are very happy with his progress and hope to build up his immunity even further.