Treatment for food allergies showing progress

ORLANDO, Fla. – Combined treatment of food allergies that includes both sublingual immunotherapy (SLIT) and oral immunotherapy appears to be effective in children who are severely allergic to milk, according to findings presented here during the 2012 Annual Meeting of the American Academy of Allergy, Asthma and Immunology.

Robert A. Wood, MD, director of Allergy & Immunology at Johns Hopkins Children’s Center, presented new study results that indicated children with severe milk allergy who received a longer schedule of sublingual immunotherapy and then moved to oral immunotherapy had less respiratory reactions, along with less frequent use of certain medications.

“While the overall result of the study, which was recently published in The Journal of Allergy and Clinical Immunology, found that oral was far more effective than sublingual immunotherapy, it was also clear that oral was associated with more significant allergic reactions to the treatment,” Wood, who is the senior study author, said in a press release.

The difference between sublingual and oral immunotherapy is that the allergen is held under the tongue with sublingual, where the allergen is simply swallowed with oral immunotherapy.

Previous research by Wood and colleagues compared sublingual therapy (allergen is held under the tongue) with oral immunotherapy (allergen is swallowed) after a short period of increasing sublingual doses. In the current study, the same researchers from Johns Hopkins and Duke University tested patients to determine if a longer period on sublingual and then oral immunotherapy would improve the safety of the treatment.

Thirty children with cow’s milk allergy were randomly placed into two groups that received either a short or longer sublingual schedule followed by oral immunotherapy. Eight patients who received sublingual therapy were moved to oral immunotherapy. After comparing reactions across the doses, the study authors concluded that the longer sublingual schedule before switching to oral immunotherapy appeared to improve safety, although it did not eliminate all symptoms. Symptoms occurred with approximately 25% of 2,251 doses.
While the overall rates of reaction between the two groups were similar, the longer sublingual immunotherapy group followed by oral immunotherapy had fewer lower and upper respiratory reactions and used antihistamines and inhaled beta-agonists less frequently, according to the study findings.

“We continue to search for the best approach for the treatment of food allergy. This study shows that for at least some children, especially those with more frequent or severe reactions to oral immunotherapy, beginning treatment with sublingual might be beneficial,” Wood said.

http://www.pediatricsupersite.com/view.aspx?rid=95272