Safety and efficacy of three office-based egg oral immunotherapy protocols.

BACKGROUND

Egg allergy is one of the most common IgE-mediated food allergies. There is no treatment approved by the US Food and Drug Administration that allows the liberalization of egg into the diet. Studies have shown that oral immunotherapy (OIT) provides protection against accidental ingestion and may also allow patients to eat egg freely, but vary in terms of protocols, efficacy, and adverse effects.

OBJECTIVE

To assess the safety and efficacy of three different office-based egg OIT protocols.

METHODS

Describe three egg OIT protocols, specifically low-dose native egg, high-dose native egg, and baked egg. Compare the safety profiles and outcomes of the three protocols.

RESULTS

A total of 96 individuals underwent egg OIT. The mean age was 8.4 years, and 43% were female. Those undergoing low-dose egg OIT had lower rates of premedication and epinephrine use compared with the other 2 OIT protocols. Of the 96 patients, 25 (26%) discontinued or were lost to follow-up; 71 (74%) could freely eat baked egg plus at least 3 g of native egg; and 57 (58%) passed a full oral food challenge to 12 g of native egg protein and liberalized their diet to include egg.

CONCLUSION

By comparing the three OIT protocols, low-dose egg OIT was shown to be well tolerated and permitted the highest rate of patients to reintroduce egg into their diets. Egg OIT is a feasible, safe, and effective therapy in the outpatient setting for the management of egg allergy.