Several clinical trials are evaluating the effectiveness of oral immunotherapy (OIT) for milk allergy, the most common food allergy in infants and young children. Early studies showed that a significant number of participants could be desensitized to milk. After swallowing small but steadily increasing doses of the allergen, they were able to eat foods containing milk without fear of severe reactions. But these studies did not go on long enough to determine if OIT could lead to tolerance – long-lasting protection against anaphylaxis that would continue after treatment was stopped.
To find the answer, researchers at Johns Hopkins and Duke universities conducted a follow-up study of 32 children who had participated in two previous milk OIT trials. When the studies ended, each of these children had passed an oral food challenge and received individualized instructions for consuming milk at home. Now – four to five years later – the researchers wanted to learn whether or not these children were still able to consume milk safely.
The results of the follow-up study, reported online in the Journal of Allergy and Clinical Immunology on June 27, were mixed. While eight of the participants had no symptoms when they consumed milk, 12 reported frequent symptoms. Six of the children experienced anaphylaxis at least once during the follow-up period, including three who reported using epinephrine at least once. The research team, led by Dr. Corinne Keet of Johns Hopkins, recommended that future trials include higher doses for longer periods of time. (Although it was not mentioned by the study authors, researchers are also exploring combination therapy. One current study, co-funded by FARE and the National Institutes of Health, is looking at the potential benefits of combining milk OIT with omalizumab, an anti-IgE medication.) The authors also concluded that OIT, which has not yet been approved by the FDA, is “far from ready” to be administered in allergists’ offices, and that more research is needed to determine its long-term results.
You can learn more about current food allergy studies at www.foodallergy.org/research.