Safety and efficacy of sublingual and oral immunotherapy for milk allergy

A study carried out by scientists from the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md, USA, has looked at the outcomes of trials using oral immunotherapy (OIT), sublingual immunotherapy (SLIT) and a combination of both for desensitizing children with cows milk allergy (CM).

Thirty subjects with cows milk allergy were enrolled, and divided into one of three groups. All subjects were given screened double-blind placebo-controlled food challenges and initial SLIT escalation, after which 10 continued SLIT escalation to 7mg a day, 10 began OIT to 1000mg (OITB group) and 10 OIT to 2000mg (OITB group).

All participants were challenged with 8mg of milk protein after 12 and 60 weeks. Participants that passed the 60-week challenge were subsequently withdrawn from therapy.

The results showed that 1 out of 10 from the SLIT group passed the 8mg challenge, 6 out of 10 from the OITB passed, and 8 out of 10 of the OITA group passed. After a period of avoidance, 3 from each of the OITB and OITA groups regained sensitivity, out of these 15 participants, two after only one week. Systemic reactions were more common during OIT than SLIT.

The scientists concluded that although OIT was more effective for desensitization to cows milk allergy than SLIT, it carried potential for more systemic reactions.

Source: Journal of Allergy and Clinical Immunology

First published November 2011

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