Oral immunotherapy with egg-white powder can lead to sustained unresponsiveness to the allergen in nearly a third of children with egg allergy, according to a New England Journal of Medicine study.

Researchers randomized 55 children (aged 5 to 11 years) with egg allergy to oral immunotherapy with egg-white powder or placebo. Immunotherapy lasted 22 months and involved dose-escalation on day one, a build-up phase, and a maintenance phase in which children consumed up to 2 g/day of egg-white powder (roughly equivalent to a third of an egg).

At 22 months, three quarters of immunotherapy recipients passed a 10-g egg-white powder challenge (no placebo recipient did). And 2 months after immunotherapy ended, 28% of treated children successfully ate a whole egg; these children were consuming eggs a year later.

In Journal Watch Pediatrics and Adolescent Medicine, David Amrol writes: “Although oral immunotherapy is our best chance for a food allergy cure, it is not ready for mainstream use until protocols are further refined. Patients who are not enrolled in clinical trials must continue to rely on allergen avoidance, patient education, and self-injectable epinephrine.”

Source: NEJM