Doctor Mònica Piquer, a member of the Department of Allergology and Clinical Immunology of the Sant Joan de Déu Hospital in Barcelona and a member of the Spanish Society of Clinical Immunology, Allergology and Pediatric Asthma (SEICAP), has emphasized that oral immunotherapy (OIT) for food allergy in children is a therapeutic approach that is "active and effective" and "allows tolerance to be achieved in a high percentage of patients," reaching "up to 80%."
As has been highlighted by this scientific society during the recent celebration in Sitges (Barcelona) of its 50th Congress, this treatment modality achieves these tolerance rates, although it "requires close monitoring and long-term maintenance."
In this context, SEICAP specialists have recalled that, "for years, the management of food allergy in childhood has been based on a clear strategy: avoiding the food that triggers symptoms." "However, this approach has been evolving and, for more than a decade, OIT, which consists of the progressive and controlled introduction of the food, has become established in Spain as an active therapeutic option for allergies to milk, egg, and nuts," they have indicated.
Doctor Olga Domínguez, also from the Department of Allergology and Clinical Immunology of the Sant Joan de Déu Hospital, has indicated that "we are facing a paradigm shift that supports early and personalized intervention, beyond avoidance, with the aim not only of preventing accidental reactions but also of modifying the natural course of the allergic disease."
Key factors for indicating oral immunotherapy
Despite its benefits, experts have stressed that "its indication must be individualized based on factors such as age, the severity of the allergy, or the presence of other pathologies, and requires careful evaluation in each case." In Piquer's words, "an inappropriate indication can generate more risks than benefits," while Doctor Cristina Blasco, a member of SEICAP's Food Allergy Working Group, has specified that "age and sensitization levels are the best predictors of success."
Piquer added that "foreseeing this risk allows for anticipation and adaptation of the therapeutic strategy", so that "measures such as starting at earlier ages or applying slower regimens with lower doses acquire special relevance, approaches that have been associated with a higher probability of remission".
Along the same lines, Dr. Carmen Riggioni, a specialist from the Division of Allergology and Immunology and Food Allergy and the Anaphylaxis Program at the Hospital for Sick Children in Toronto (Canada), has pointed out that "simultaneous oral immunotherapy to multiple foods, with slow regimens and low doses, has proven to be feasible and effective in inducing desensitization to several allergens simultaneously".
Regarding the role of biological drugs, Dr. Daniel Lozano-Ojalvo, a tenured scientist at the Spanish National Research Council (CSIC), has pointed out that "some" of these treatments "have shown to offer protection against allergic reactions, but their use must be individualized and requires careful assessment of the benefit-risk balance". SEICAP has stressed that "food allergy does not currently constitute an approved indication in its technical data sheet" for these medications.