THE QUESTION Children allergic to a food such as eggs, milk or peanuts have to avoid it entirely. Might oral immunotherapy — a treatment that involves eating a gradually increasing amount of the food they’re allergic to — improve their tolerance and ease allergic reactions?
THIS STUDY randomly assigned 55 children, 5 to 11 years old who were moderately allergic to eggs, to have either an egg-white powder or a placebo (cornstarch) mixed into their regular food each day in escalating amounts. After 10 months, 55 percent of the children who had been consuming increasing amounts of the powder were able to eat five grams of it (equal to a little more than half an egg) with minimal or no allergic symptoms, compared with none of the children who had been given cornstarch. Tested again at 22 months, 75 percent of the children in the egg powder group tolerated 10 grams. Two years after the study started, 11 children were considered cured of their allergy and able to eat eggs whenever they wanted without problems. During the study, about three-fourths of the children in the egg group experienced some type of reaction, but none were serious and most resolved without treatment. However, six children dropped out of the study because of allergic reactions.
WHO MAY BE AFFECTED? Children allergic to eggs, one of the most common childhood allergies. In the United States, about 4 percent of children have a food allergy, a number that has increased in the past decade. Children with a food allergy are more than twice as likely as their peers to have other allergies or asthma. Children often outgrow their food allergy, but for some it remains a lifelong issue.
CAVEATS Whether oral immunotherapy might help severely allergic children remains unclear because they were not included in the study. The results also may not apply to children with other food allergies or to adults. Exposing children to a food they’re allergic to can be extremely risky and should not be tried except under medical supervision.
FIND THIS STUDY July 19 issue of the New England Journal of Medicine (www.nejm.org).
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.