Oral Immunotherapy in Children: Clinical Considerations and Practical Management

Brent Anderson, Lauren Wong, Bahman Adlou, Andrew Long, R Sharon Chinthrajah Sean N Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, CA, USACorrespondence: R Sharon ChinthrajahSean N Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, 240 Pasteur Dr BMI #1454, Palo Alto, CA, USATel +1 650 521 7237Fax +1 650 724 0198Email schinths@stanford.eduAbstract: Oral immunotherapy (OIT) in pediatric patients provides an alternative option to the current standard of care in food allergy, which is allergen avoidance and reactive treatment. Because patients are exposed to one or more food allergens during treatment, OIT is associated with adverse events and can be a cumbersome process for children, their caregivers, and clinicians. However, there have been an overwhelming number of studies that show high efficacy in both single- and multi-allergen OIT, and that quality of life is greatly improved for both patients and their families after undergoing immunotherapy. This review discusses clinical considerations for OIT in pediatrics, including efficacy and safety, practical management, and future directions of treatment.Keywords: food allergy, atopy, desensitization, tolerance, omalizumab, dupilumab, IgE, sustained unresponsiveness