Food Allergy Treatment Comparison
Oral Immunotherapy (OIT)
Eating the allergenic foods in gradually increasing amounts
Advantages:
-Can be used to treat multiple allergens simultaneously
-Can be effective in kids as young as 12 months old
-Can give larger maintenance doses (g) than SLIT/EPIT (mg)
-More effective than SLIT
Disdvantages:
-Greatest side effects (although mostly mild)
-Not tolerated in 15%-20% of patients
-Potential for eosinophilic esophagitis (EoE)-predicted up to about 2.7%
-Requires long-term adherence
Oral Immunotherapy with Xolair
Eating the allergenic foods orally in gradually increasing amounts with addition of Xolair to accelerate the process
Advantages:
-Can be used to treat multiple allergens simultaneously
-Can give larger maintenance doses (g) than SLIT/EPIT (mg)
-More effective than SLIT
-Accelerates the process significantly
Disadvantages:
-Xolair is not currently approved by the US FDA for food allergy*
-May be cost-prohibitive for some
-Typically not used in children under 4 years old
Sublingual Immunotherapy (SLIT)
Placing allergen extract drops under the tongue in gradually increasing amounts
Advantages:
-Fewer side effects than OIT
-Not tolerated in 5% of subjects
Disadvantages:
-Only able to reach small maintenance doses
-Typically only used for one allergen at a time
-Not as effective as OIT
-Requires long-term adherence
Epicutaneous Immunotherapy (EPIT)
Wearing a patch containing the food allergen on the skin
Advantages:
-May have fewer side effects than SLIT and OIT
-May be safer in broader clinical settings
Disdvantages:
-Only available in clinical trials; not available for public use yet
-Only used for one allergen at a time
-Only able to reach small maintenance doses
-May only be as effective as SLIT, likely less than OIT
-May not be ideal in patients with atopic dermatitis
-May not be as effective in older kids/adults
Chinese food allergy herbal formula-2 (FAHF-2)
Orally ingesting a compound of 9 different traditional Chinese herbs
Advantages:
-May have the fewest side effects
Disadvantages:
-May not work well when used alone (without adjunct therapy)
Probiotics
Supplementing the diet with beneficial bacteria
Advantages:
-May have the fewest side effects
-May be beneficial to reduce side effects when combined with OIT
Disdvantages:
-Not shown to work when used alone (without adjunct therapy)