Oral Immunotherapy (OIT)
WE CURRENTLY OFFER OIT FOR: PEANUT, TREE NUTS (ALMOND, CASHEW/PISTACHIO, WALNUT/PECAN, HAZELNUT), SESAME, MILK, EGG, WHEAT, SOY, SUNFLOWER, PINE NUT.
Food allergy is a potentially life threatening condition. Standard management has been strict food avoidance and preparedness with an epinephrine auto injector in the event of a reaction. However, despite efforts at avoidance, severe reactions can still occur and may be triggered by very small exposures and cross contamination.
Oral immunotherapy (OIT) is a program of supervised food ingestion undertaken for the treatment of food allergy. OIT refers to feeding an allergic individual an increasing amount of an allergen with the goal of increasing the threshold that triggers a reaction. For example, a person allergic to peanuts may be given very small amounts of peanut protein that would not trigger a reaction. This small amount is gradually increased in the allergist’s office or a clinical research setting over a period of months. The goal of therapy is to raise the threshold that may trigger a reaction and provide the allergic individual protection against accidental ingestion of the allergen. OIT is not a curative therapy. Individuals who receive OIT must continue to carry epinephrine and read labels closely. In most cases, receiving OIT does not mean the patient can ingest the allergen without limitation.
Some individuals undergoing OIT may be able to “Free eat” the OIT food. The term “Free eat” means the patient may consume the OIT food as desired in addition to taking the maintenance dose regularly on a frequency determined by your Allergist. In order to “Free eat” an OIT food, one must reach a higher maintenance dose than described above (extending the estimated time of the protocol), pass an oral challenge to a larger dose of OIT food than the maintenance dose, and follow restrictions, including but not limited to exercise limitation, around the time of food consumption. Your Allergist may place additional restrictions on “Free eating” at his/her professional discretion for your safety. “Free eating” an OIT food may not be possible for all individuals undergoing the OIT process and should never be done while undergoing OIT unless expressly permitted by your Allergist. Your Allergist will determine whether “Free eating” may be an option for you.
OIT is food specific and will treat only the food allergy for which the OIT is being undertaken. The only exception to this is for tree nuts where two or more tree nuts may be similar enough that treatment with one tree nut offers protection against another; if this is the case for you, this will be discussed by your Allergist.
Each patient’s oral immunotherapy schedule is specifically tailored based upon the individual’s history and food(s) to which he/she is allergic. Initially, oral immunotherapy is begun at very small doses, and the dose is gradually increased until a therapeutic dose (called the maintenance dose) is achieved . The dose is typically increased every 1-4 weeks (called the up dosing phase). The initial office visit typically lasts 2-3 hours and the weekly to bi-weekly to monthly up dosing office visits last approximately 1 hour; all visits are done under physician supervision for safety reasons. In between office visits, you will continue to take a daily dose of OIT at home as determined by your allergist. Your Allergist will review your tolerance of this daily dose prior to every new up dose and may make modification to your up dosing schedule or final maintenance dose as needed.