Egg oral immunotherapy could be safe way of desensitizing children, youth with egg allergy

UNC School of Medicine researcher Edwin Kim, MD, MS, says the results of a multi-year observational study are encouraging for those suffering from egg allergies.

After completing up to four years of egg oral immunotherapy (eOIT) treatment, certain participants were able to safely incorporate egg into their diet for five years. This new research was presented by the study's first author, Edwin Kim, MD, at the annual American Academy of Allergy, Asthma and Immunology (AAAAI) conference in San Francisco.

"Egg allergy is one of the most common food allergies and usually appears in early childhood. It has significant risk for severe allergic reactions and negatively affects quality of life for children with the allergy," said Kim, assistant professor of medicine and pediatrics at the UNC School of Medicine and director of the UNC Food Allergy Initiative. "While the allergy does seem to go away with age, it can last into the second decade of life for most people. Any treatment that can allow the introduction of egg into the diet of someone with egg allergy provides nutritional benefits and peace of mind for the patient and their family."

UNC School of Medicine was one of five centers to participate in the study, led by the Consortium of Food Allergy Research (COFAR) and funded by the National Institutes of Health (NIH). The trial began with either eOIT or a placebo for 55 patients aged 5-11 who were allergic to egg. The treatments were randomized - 40 participants received eOIT and 15 received the placebo.

The treatments lasted up to four years, during which patients were tested for their sensitivity to egg. Those who were considered desensitized - requiring a higher quantity of egg to cause an allergic reaction - could eat 10 grams, or about two teaspoons, of pure egg without reaction. Desensitized patients then stopped eOIT and were tested for sensitivity again. Those who did not have a reaction were considered sustained unresponsiveness (SU). After completing eOIT, concentrated egg (scrambled, fried or boiled egg) and/or baked egg (eggs incorporated into something like a cake) were recommended to be added into the patients' diet. For five years following the allergy treatment, patients were asked to report how much egg they ate, in what form they ate it, how often they ate it and how they felt afterward.

At the end of eOIT, 50 percent of patients were classified with SU, 28 percent of patients were classified as desensitized (without SU) and 22 percent as not desensitized. Of SU-classified patients, 100 percent were able to eat both baked and concentrated egg.

Desensitized, not desensitized, and placebo groups had more variable ingestion of baked and concentrated egg and had more chance of symptoms from ingestion.

"These results further support the effectiveness of eOIT as a safe way of desensitizing children and youth with egg allergy," said Kim. "Past research also suggests that eating egg may actually shorten the amount of time a patient has the allergy, so any amount of egg that is incorporated into an allergy patient's diet is helpful."