Outcomes of Food Allergen Oral Immunotherapy following Clinical Trial Participation

Oral immunotherapy (OIT) clinical trials for food allergy have been performed at our institution since 2012. We completed 5 OIT trials over the last 6 years. Limited knowledge exists about what happens to study participants over time. We conducted an IRB approved retrospective chart review of all subjects who completed participation in an OIT clinical trial at our institution. Thirty-nine participants were included. Most participants were male (69.2%) and Caucasian (66.7 %). The average age was 9.9 years (range 4-17). Twenty-five (64.1%) consumed peanut products, 7 (17.9%) consumed peanut plus at least one other allergen, and 7 (17.9%) consumed wheat products. Following clinical trial completion, those subjects who achieved desensitization and expressed interest in maintaining protection were transitioned to consumption of commercially available food allergen. Currently, 23 (59.0 %) continue to ingest their culprit allergen from once daily to once every 2 weeks while 16 (41.0 %) have discontinued consumption due to adverse events (AEs) or personal preference. Three (7.7%) subjects stopped ingesting their food allergen as soon as the trials they were in was completed. 14 participants attended our post-trial clinic for continued up-dosing. Although reactions have occurred in this cohort, gastrointestinal symptoms/eosinophilic esophagitis have not developed. OIT is a successful desensitization method for food allergy, however not all post-trial subjects continue to ingest their allergen once desensitized. Those who transitioned to commercially available products containing their food allergen have been successful, and continued up-dosing has enabled participants to ingest greater amounts of their allergen(s) with few AEs.