Information updates

ASCIA Oral Immunotherapy (OIT) for Food Allergy Update

3 December 2020

Oral immunotherapy (OIT) is a potential treatment for food allergy. It involves giving gradually increasing amounts of food allergen under medical supervision and continued daily consumption of the food allergen. If the goal of desensitisation is reached, there is a temporary increase in the amount of food allergen that can be consumed before an allergic reaction occurs.

Food allergy OIT is an emerging treatment, and there are currently several clinical trials of OIT and other treatments for food allergy underway in Australia and other countries.

ASCIA information on OIT for food allergy has been updated to include the following new information.

Considerations prior to commencing a food allergy OIT clinical trial

Food allergy OIT should be given in a consistent way, to maximise its chances of effectiveness and minimise the risk of side effects. Therefore, being in a food allergy OIT clinical trial may present difficulties for people who plan to go on active holidays, overnight excursions, camps, or board overnight at school. There will also be some inconveniences, potential lifestyle disruptions and restrictions while being in a food allergy OIT clinical trial that need to be carefully considered.

Each dose of OIT carries a risk of an allergic reaction, including anaphylaxis, so taking on responsibility for dosing a student taking food allergy OIT cannot be expected of every school. When students are on overnight school excursions or camps, there can be changes in sleep patterns, busy activity schedules, lower ratios of carers to students and remote or unfamiliar locations. These are all factors that can increase the risk of an allergic reaction with a dose of food allergy OIT. There also increased risks of an allergic reaction for a person on OIT who has an infection, poorly controlled asthma or allergic rhinitis.

Therefore, people on food allergy OIT may need to choose between attending school activities and interrupting OIT, depending on discussions with schools and camps or other factors. These factors should also be considered for people going on active holidays or other activities with their family or friends.

There are added risks when food allergy OIT is recommenced after a long interruption. For this reason, the OIT clinical trial doctor or treating clinical immunology/allergy specialist may recommend that this occurs in a supervised medical setting, in a similar way to a food allergen challenge. There are often long waiting times to access food allergen challenges outside of research settings. Therefore, a treating clinical immunology/allergy specialist may not be able to offer rapid access to a suitable setting for recommencing food allergy OIT when interruptions occur.