Safety and Effectiveness of Bypassing Oral Immunotherapy Buildup With an Initial Phase of Sublingual Immunotherapy for Higher-Risk Food Allergy

Because of its favorable safety, sublingual immunotherapy (SLIT) for food allergy has been proposed as an alternative treatment for those in whom oral immunotherapy (OIT) is of higher risk—older children, adolescents, adults, and those with a history of severe reactions. Although safe, SLIT has been...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The journal of allergy and clinical immunology in practice (Cambridge, MA) MA), 2024-05, Vol.12 (5), p.1283-1296.e2
Hauptverfasser: Soller, Lianne, Williams, Brock A., Mak, Raymond, Wong, Tiffany, Erdle, Stephanie C., Chomyn, Alanna, Tetreault, Brittany, Morrison, Kelly, Gaudet, Lisa, Chan, Edmond S.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 1296.e2
container_issue 5
container_start_page 1283
container_title The journal of allergy and clinical immunology in practice (Cambridge, MA)
container_volume 12
creator Soller, Lianne
Williams, Brock A.
Mak, Raymond
Wong, Tiffany
Erdle, Stephanie C.
Chomyn, Alanna
Tetreault, Brittany
Morrison, Kelly
Gaudet, Lisa
Chan, Edmond S.
description Because of its favorable safety, sublingual immunotherapy (SLIT) for food allergy has been proposed as an alternative treatment for those in whom oral immunotherapy (OIT) is of higher risk—older children, adolescents, adults, and those with a history of severe reactions. Although safe, SLIT has been shown to be less effective than OIT. To describe the safety of multifood SLIT in pediatric patients aged 4 to 18 years and the effectiveness of bypassing OIT buildup with an initial phase of SLIT. Patients aged 4 to 18 years were offered (multi)food SLIT. Patients built up to 2 mg protein SLIT maintenance over the course of 3 to 5 visits under nurse supervision. After 1 to 2 years of daily SLIT maintenance, patients were offered a low-dose oral food challenge (OFC) (cumulative dose, 300 mg protein) with the goal of bypassing OIT buildup. Between summer 2020 and winter 2023, 188 patients were enrolled in SLIT (median age, 11 years). Four patients (2.10%) received epinephrine during buildup and went to the emergency department, but none experienced grade 4 (severe) reaction. A subset of 20 patients had 50 low-dose OFCs to 300 mg protein and 35 (70%) OFCs were successful, thereby bypassing OIT buildup. In combination with very favorable safety of SLIT, with no life-threatening reactions and few reactions requiring epinephrine, we propose that an initial phase of SLIT to bypass supervised OIT buildup be considered for children in whom OIT is considered to be of higher risk.
doi_str_mv 10.1016/j.jaip.2024.02.024
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2934274809</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2213219824001983</els_id><sourcerecordid>2934274809</sourcerecordid><originalsourceid>FETCH-LOGICAL-c351t-22cba0a1b2da5fd31373a3e2f4a1df4edac6c95edf9ef0ccbfb6337156d3c6153</originalsourceid><addsrcrecordid>eNp9kd1KxDAQhYMoKuoLeCG59GbX_LW7BW9UVl0QFH_wMqTJZDdr29SkFfoUvrJZVr0RHAYmgfMdmDkIHVMypoTmZ6vxSrl2zAgTY8JSiy20zxjlI8YI3f5502K6h45iXJFUUzohguyiPT4VjLOC76PPJ2WhG7BqDJ5ZC7pzH9BAjNhbfDm0KkbXLPB9UBWe13Xf-G4JQbUDvuxdZfoWv7pumXA8b1znkuphqSKs6ae-rBLb_yGtD_jWLdJv9OjiG7723uCLqoKwGA7RjlVVhKPveYBermfPV7eju_ub-dXF3UjzjHZpR10qomjJjMqs4ZRPuOLArFDUWAFG6VwXGRhbgCVal7bMOZ_QLDdc5zTjB-h049sG_95D7GTtooaqUg34Psp0HMEmYkqKJGUbqQ4-xgBWtsHVKgySErnOQq7kOgu5zkISllok6OTbvy9rML_Iz-WT4HwjgLTlh4Mgo3bQaDAupBSk8e4__y83P516</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2934274809</pqid></control><display><type>article</type><title>Safety and Effectiveness of Bypassing Oral Immunotherapy Buildup With an Initial Phase of Sublingual Immunotherapy for Higher-Risk Food Allergy</title><source>Alma/SFX Local Collection</source><creator>Soller, Lianne ; Williams, Brock A. ; Mak, Raymond ; Wong, Tiffany ; Erdle, Stephanie C. ; Chomyn, Alanna ; Tetreault, Brittany ; Morrison, Kelly ; Gaudet, Lisa ; Chan, Edmond S.</creator><creatorcontrib>Soller, Lianne ; Williams, Brock A. ; Mak, Raymond ; Wong, Tiffany ; Erdle, Stephanie C. ; Chomyn, Alanna ; Tetreault, Brittany ; Morrison, Kelly ; Gaudet, Lisa ; Chan, Edmond S.</creatorcontrib><description>Because of its favorable safety, sublingual immunotherapy (SLIT) for food allergy has been proposed as an alternative treatment for those in whom oral immunotherapy (OIT) is of higher risk—older children, adolescents, adults, and those with a history of severe reactions. Although safe, SLIT has been shown to be less effective than OIT. To describe the safety of multifood SLIT in pediatric patients aged 4 to 18 years and the effectiveness of bypassing OIT buildup with an initial phase of SLIT. Patients aged 4 to 18 years were offered (multi)food SLIT. Patients built up to 2 mg protein SLIT maintenance over the course of 3 to 5 visits under nurse supervision. After 1 to 2 years of daily SLIT maintenance, patients were offered a low-dose oral food challenge (OFC) (cumulative dose, 300 mg protein) with the goal of bypassing OIT buildup. Between summer 2020 and winter 2023, 188 patients were enrolled in SLIT (median age, 11 years). Four patients (2.10%) received epinephrine during buildup and went to the emergency department, but none experienced grade 4 (severe) reaction. A subset of 20 patients had 50 low-dose OFCs to 300 mg protein and 35 (70%) OFCs were successful, thereby bypassing OIT buildup. In combination with very favorable safety of SLIT, with no life-threatening reactions and few reactions requiring epinephrine, we propose that an initial phase of SLIT to bypass supervised OIT buildup be considered for children in whom OIT is considered to be of higher risk.</description><identifier>ISSN: 2213-2198</identifier><identifier>EISSN: 2213-2201</identifier><identifier>DOI: 10.1016/j.jaip.2024.02.024</identifier><identifier>PMID: 38423293</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Effectiveness of food allergy treatment ; Food allergy ; Food allergy immunotherapy ; Food allergy treatment ; Multiple food allergy ; Safety of food allergy treatment ; Sublingual immunotherapy ; Sublingual treatment</subject><ispartof>The journal of allergy and clinical immunology in practice (Cambridge, MA), 2024-05, Vol.12 (5), p.1283-1296.e2</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c351t-22cba0a1b2da5fd31373a3e2f4a1df4edac6c95edf9ef0ccbfb6337156d3c6153</cites><orcidid>0000-0003-3542-3241</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38423293$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soller, Lianne</creatorcontrib><creatorcontrib>Williams, Brock A.</creatorcontrib><creatorcontrib>Mak, Raymond</creatorcontrib><creatorcontrib>Wong, Tiffany</creatorcontrib><creatorcontrib>Erdle, Stephanie C.</creatorcontrib><creatorcontrib>Chomyn, Alanna</creatorcontrib><creatorcontrib>Tetreault, Brittany</creatorcontrib><creatorcontrib>Morrison, Kelly</creatorcontrib><creatorcontrib>Gaudet, Lisa</creatorcontrib><creatorcontrib>Chan, Edmond S.</creatorcontrib><title>Safety and Effectiveness of Bypassing Oral Immunotherapy Buildup With an Initial Phase of Sublingual Immunotherapy for Higher-Risk Food Allergy</title><title>The journal of allergy and clinical immunology in practice (Cambridge, MA)</title><addtitle>J Allergy Clin Immunol Pract</addtitle><description>Because of its favorable safety, sublingual immunotherapy (SLIT) for food allergy has been proposed as an alternative treatment for those in whom oral immunotherapy (OIT) is of higher risk—older children, adolescents, adults, and those with a history of severe reactions. Although safe, SLIT has been shown to be less effective than OIT. To describe the safety of multifood SLIT in pediatric patients aged 4 to 18 years and the effectiveness of bypassing OIT buildup with an initial phase of SLIT. Patients aged 4 to 18 years were offered (multi)food SLIT. Patients built up to 2 mg protein SLIT maintenance over the course of 3 to 5 visits under nurse supervision. After 1 to 2 years of daily SLIT maintenance, patients were offered a low-dose oral food challenge (OFC) (cumulative dose, 300 mg protein) with the goal of bypassing OIT buildup. Between summer 2020 and winter 2023, 188 patients were enrolled in SLIT (median age, 11 years). Four patients (2.10%) received epinephrine during buildup and went to the emergency department, but none experienced grade 4 (severe) reaction. A subset of 20 patients had 50 low-dose OFCs to 300 mg protein and 35 (70%) OFCs were successful, thereby bypassing OIT buildup. In combination with very favorable safety of SLIT, with no life-threatening reactions and few reactions requiring epinephrine, we propose that an initial phase of SLIT to bypass supervised OIT buildup be considered for children in whom OIT is considered to be of higher risk.</description><subject>Effectiveness of food allergy treatment</subject><subject>Food allergy</subject><subject>Food allergy immunotherapy</subject><subject>Food allergy treatment</subject><subject>Multiple food allergy</subject><subject>Safety of food allergy treatment</subject><subject>Sublingual immunotherapy</subject><subject>Sublingual treatment</subject><issn>2213-2198</issn><issn>2213-2201</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kd1KxDAQhYMoKuoLeCG59GbX_LW7BW9UVl0QFH_wMqTJZDdr29SkFfoUvrJZVr0RHAYmgfMdmDkIHVMypoTmZ6vxSrl2zAgTY8JSiy20zxjlI8YI3f5502K6h45iXJFUUzohguyiPT4VjLOC76PPJ2WhG7BqDJ5ZC7pzH9BAjNhbfDm0KkbXLPB9UBWe13Xf-G4JQbUDvuxdZfoWv7pumXA8b1znkuphqSKs6ae-rBLb_yGtD_jWLdJv9OjiG7723uCLqoKwGA7RjlVVhKPveYBermfPV7eju_ub-dXF3UjzjHZpR10qomjJjMqs4ZRPuOLArFDUWAFG6VwXGRhbgCVal7bMOZ_QLDdc5zTjB-h049sG_95D7GTtooaqUg34Psp0HMEmYkqKJGUbqQ4-xgBWtsHVKgySErnOQq7kOgu5zkISllok6OTbvy9rML_Iz-WT4HwjgLTlh4Mgo3bQaDAupBSk8e4__y83P516</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Soller, Lianne</creator><creator>Williams, Brock A.</creator><creator>Mak, Raymond</creator><creator>Wong, Tiffany</creator><creator>Erdle, Stephanie C.</creator><creator>Chomyn, Alanna</creator><creator>Tetreault, Brittany</creator><creator>Morrison, Kelly</creator><creator>Gaudet, Lisa</creator><creator>Chan, Edmond S.</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3542-3241</orcidid></search><sort><creationdate>20240501</creationdate><title>Safety and Effectiveness of Bypassing Oral Immunotherapy Buildup With an Initial Phase of Sublingual Immunotherapy for Higher-Risk Food Allergy</title><author>Soller, Lianne ; Williams, Brock A. ; Mak, Raymond ; Wong, Tiffany ; Erdle, Stephanie C. ; Chomyn, Alanna ; Tetreault, Brittany ; Morrison, Kelly ; Gaudet, Lisa ; Chan, Edmond S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-22cba0a1b2da5fd31373a3e2f4a1df4edac6c95edf9ef0ccbfb6337156d3c6153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Effectiveness of food allergy treatment</topic><topic>Food allergy</topic><topic>Food allergy immunotherapy</topic><topic>Food allergy treatment</topic><topic>Multiple food allergy</topic><topic>Safety of food allergy treatment</topic><topic>Sublingual immunotherapy</topic><topic>Sublingual treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soller, Lianne</creatorcontrib><creatorcontrib>Williams, Brock A.</creatorcontrib><creatorcontrib>Mak, Raymond</creatorcontrib><creatorcontrib>Wong, Tiffany</creatorcontrib><creatorcontrib>Erdle, Stephanie C.</creatorcontrib><creatorcontrib>Chomyn, Alanna</creatorcontrib><creatorcontrib>Tetreault, Brittany</creatorcontrib><creatorcontrib>Morrison, Kelly</creatorcontrib><creatorcontrib>Gaudet, Lisa</creatorcontrib><creatorcontrib>Chan, Edmond S.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of allergy and clinical immunology in practice (Cambridge, MA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soller, Lianne</au><au>Williams, Brock A.</au><au>Mak, Raymond</au><au>Wong, Tiffany</au><au>Erdle, Stephanie C.</au><au>Chomyn, Alanna</au><au>Tetreault, Brittany</au><au>Morrison, Kelly</au><au>Gaudet, Lisa</au><au>Chan, Edmond S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and Effectiveness of Bypassing Oral Immunotherapy Buildup With an Initial Phase of Sublingual Immunotherapy for Higher-Risk Food Allergy</atitle><jtitle>The journal of allergy and clinical immunology in practice (Cambridge, MA)</jtitle><addtitle>J Allergy Clin Immunol Pract</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>12</volume><issue>5</issue><spage>1283</spage><epage>1296.e2</epage><pages>1283-1296.e2</pages><issn>2213-2198</issn><eissn>2213-2201</eissn><abstract>Because of its favorable safety, sublingual immunotherapy (SLIT) for food allergy has been proposed as an alternative treatment for those in whom oral immunotherapy (OIT) is of higher risk—older children, adolescents, adults, and those with a history of severe reactions. Although safe, SLIT has been shown to be less effective than OIT. To describe the safety of multifood SLIT in pediatric patients aged 4 to 18 years and the effectiveness of bypassing OIT buildup with an initial phase of SLIT. Patients aged 4 to 18 years were offered (multi)food SLIT. Patients built up to 2 mg protein SLIT maintenance over the course of 3 to 5 visits under nurse supervision. After 1 to 2 years of daily SLIT maintenance, patients were offered a low-dose oral food challenge (OFC) (cumulative dose, 300 mg protein) with the goal of bypassing OIT buildup. Between summer 2020 and winter 2023, 188 patients were enrolled in SLIT (median age, 11 years). Four patients (2.10%) received epinephrine during buildup and went to the emergency department, but none experienced grade 4 (severe) reaction. A subset of 20 patients had 50 low-dose OFCs to 300 mg protein and 35 (70%) OFCs were successful, thereby bypassing OIT buildup. In combination with very favorable safety of SLIT, with no life-threatening reactions and few reactions requiring epinephrine, we propose that an initial phase of SLIT to bypass supervised OIT buildup be considered for children in whom OIT is considered to be of higher risk.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38423293</pmid><doi>10.1016/j.jaip.2024.02.024</doi><orcidid>https://orcid.org/0000-0003-3542-3241</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2213-2198
ispartof The journal of allergy and clinical immunology in practice (Cambridge, MA), 2024-05, Vol.12 (5), p.1283-1296.e2
issn 2213-2198
2213-2201
language eng
recordid cdi_proquest_miscellaneous_2934274809
source Alma/SFX Local Collection
subjects Effectiveness of food allergy treatment
Food allergy
Food allergy immunotherapy
Food allergy treatment
Multiple food allergy
Safety of food allergy treatment
Sublingual immunotherapy
Sublingual treatment
title Safety and Effectiveness of Bypassing Oral Immunotherapy Buildup With an Initial Phase of Sublingual Immunotherapy for Higher-Risk Food Allergy
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T02%3A26%3A29IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Safety%20and%20Effectiveness%20of%20Bypassing%20Oral%20Immunotherapy%20Buildup%20With%20an%20Initial%20Phase%20of%20Sublingual%20Immunotherapy%20for%20Higher-Risk%20Food%20Allergy&rft.jtitle=The%20journal%20of%20allergy%20and%20clinical%20immunology%20in%20practice%20(Cambridge,%20MA)&rft.au=Soller,%20Lianne&rft.date=2024-05-01&rft.volume=12&rft.issue=5&rft.spage=1283&rft.epage=1296.e2&rft.pages=1283-1296.e2&rft.issn=2213-2198&rft.eissn=2213-2201&rft_id=info:doi/10.1016/j.jaip.2024.02.024&rft_dat=%3Cproquest_cross%3E2934274809%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2934274809&rft_id=info:pmid/38423293&rft_els_id=S2213219824001983&rfr_iscdi=true