Oral therapy can benefit egg-allergic children

Investigators assessed the efficacy of oral immunotherapy in children with egg allergy in inducing "sustained unresponsiveness" to egg allergen, a greater clinical effect than "desensitization."

In a multicenter trial, 55 children aged 5 to 11 years had a clinical history of egg allergy and a serum egg-specific immunoglobulin E (IgE) antibody level high enough to exclude children who were likely to outgrow the allergy during the course of the 36-month study.

Forty children were given egg-white powder and 15 children placebo in the first phase of the study, which was followed by an oral food challenge with egg-white powder at 10 and 22 months.

Children who passed this food challenge were allowed free access to eggs; at 30 and 36 months, all these children were eating egg. In addition, passing the oral food challenge at 24 months was associated with increases in egg-specific IgE antibody.

Although no severe adverse events were reported, about 78% of children in the oral immunotherapy group had oral or pharyngeal symptoms (Burks AW, et al. N Engl J Med. 2012;367[3]:233-243).

Commentary

It is unlikely that you'll be using this information on your own in the office, but it is helpful to know that there may be options for treatment of children with severe egg allergy. It may be time to talk again to your allergy consultant about that severely egg-allergic patient in your practice. -Michael Burke, MD