OIT has been successful at decreasing food allergic sensitivity. This was originally designed to make food allergic patients less sensitive so cross contamination from a factory or food exposure would be less likely to cause a severe allergic reaction known as anaphylaxis. Additional research has proven that many patients desensitize enough where they become tolerant to their allergens and can ingest without any risk of anaphylaxis.
Step 1 of OIT involves appropriate history and lab work to determine which patients may be eligible. This can occur during an initial office visit or follow up for our existing patients.
Step 2 of OIT patients will receive rapid desensitization over a 4-6 hour visit. During this time incremental increasing amount of an allergen is ingested while patients are closely monitored for evidence of a reaction. The patients are then discharged to home while maintaining their daily dose for at least 7 days.
Step 3 is referred to as “updosing”. Patients will have their daily at home dose increased during this 45-60 minute office visit.
Step 4 is maintenance when the desired top dosage is achieved. Patients will then be followed and appropriate labs will be monitored. A second food allergen can be introduced after this time.
OIT success rates are above 80%. Potential side effects are mild to more severe allergic reactions. Less than 5% of patients develop Eosinophilic Esophagitis(EOE) which would be criteria to discontinue this desensitization. Patients who have their environmental allergens, asthma and atopic dermatitis poorly controlled are not candidates for OIT. Additional contraindications include idiopathic anaphylaxis, MAST cell disease, FPIES and poorly controlled GERD or existing EOE.
We have being doing successful updosing in our practice for over 2 years from Drs Mayer and Silver from Michigan and Cleveland, respectively. We will be following strict criteria for advancing OIT.
As of October 8TH, 2018 we will be booking patients for OIT. Call to schedule an appointment (Step 1). We are looking forward to seeing many smiles on our patient’s and families faces.