Frequently asked questions
WHAT IS ORAL IMMUNOTHERAPY (OIT)?
Oral immunotherapy is a treatment in which ingestion of a small amount of a food allergen on a daily basis leads to a state whereby an allergen can be eaten without having a reaction. This is known as desensitization.
WHAT IS THE GOAL OF OIT?
The goal of oral immunotherapy is to be able to eat products that contain the allergen without the constant fear of having a reaction.
IS OIT A CURE FOR FOOD ALLERGIES?
No. It is not a cure because when/if the daily dosage is stopped, many individuals may return to the allergic state and thus lose the desensitized state. Current research studies are looking at ways to induce immune tolerance, i.e. the ability to eat the food without reaction after stopping the daily dosage.
WHO ARE GOOD CANDIDATES FOR OIT?
Individuals who wish to reduce the risk of an allergic reaction in the event of accidental ingestion and will be compliant with the dosing regimen.
WHO SHOULD NOT PARTICIPATE IN OIT?
HOW MANY VISITS TO THE ALLERGY OFFICE ARE THERE?
The number of visits to the allergy office will depend on the number of allergens used, the target maintenance dosage and whether or not you use Xolair (explained later). This will be determined after your consultation with our OIT team. With Xolair, there could be as few as 3 appointments in the allergy office. Without Xolair there could be as few as 14 appointments in the allergy office. The exact duration will vary by individual depending on adjustments in dosage that may need to be made if there are symptoms, illness, and/or other reasons why dosing needs to be adjusted. We are able to individualize therapy to maximize safety, comfort and convenience.
WHAT DOES THE VISIT SCHEDULE LOOK LIKE IF I DO OIT WITH XOLAIR?
WHAT DOES THE VISIT SCHEDULE LOOK LIKE IF I DO OIT WITHOUT XOLAIR?
WHAT IS THE RISK OF AN ALLERGIC REACTION DURING OIT?
Studies show that many patients will exhibit symptoms at some point during the immunotherapy process. Reactions more commonly occur during the dose escalation phase (also called the build-up phase), although they can occur at any time during therapy. The majority of reactions are treated successfully with an antihistamine only. The most common reactions include an itchy mouth and mild abdominal pain and/or vomiting. A recent chart review of oral immunotherapy with peanut conducted in 5 private allergy clinics reported epinephrine use was uncommon (0.2% to 0.7%...that's about 2 to 7 out of 1000 doses). Although this is reassuring data, you or a caregiver should always have readily accessible epinephrine and follow your emergency food action plan. (Wasserman et al, J Allergy Clin Immunol Pract. 2014 Jan-Feb;2(1):91-6)
IS A CLINICIAN AVAILABLE IF I HAVE A REACTION OR URGENT DOSING QUESTION WHEN I'M NOT IN CLINIC?
Yes, a clinician (NP, PA, or MD) is available for urgent medical questions until you have been at your maintenance dose for 6 months. After you have been at your maintenance dose for 6 months we recommend you direct urgent medical questions to your primary allergist. As always, you never need anyone’s permission to use epinephrine. If you have an emergency that requires epinephrine, please inject, call 911 and get yourself safely on the way to the emergency room.
WHAT FOOD ALLERGENS ARE OPTIONS TO BE INCLUDED IN OIT?
ONCE I OR MY CHILD REACHES THE MAINTENANCE DOSE, WILL I/MY CHILD HAVE TO EAT THAT EVERY DAY FOREVER?
Probably not, but for the immediate future, yes. The goal of our protocol is to induce a desensitized state. This means you have to eat the food to continue to tolerate it without having a reaction. If you avoid the food you were desensitized to and then come back and eat it without reaction you are not just desensitized, you are scientifically tolerant. Research is currently being done to determine the safest and best way to achieve scientific tolerance. We will let you know at follow-up appointments as research emerges the safest and best dosing plan.
HOW DO I START THE OIT PROCESS?
If you are interested in proceeding with OIT at the National Allergy Center, please schedule a complimentary phone consult by completing the form on our website, www.nationalallergycenter.com or call 1-855-FIND-OIT (855-346-3648).