Oral Immunotherapy, Sublingual Immunotherapy, or Epicutaneous Immunotherapy: Which Is the Right Solution?

Opinion statement

The current standard of care treatment for food allergy relies on avoidance. However, as outlined in this review, over the past decade, the literature has grown significantly showing promising results for interventional therapies for IgE-mediated food allergies utilizing oral immunotherapy (OIT), sublingual immunotherapy (SLIT), and epicutaneous immunotherapy (EPIT). Within the near future, we expect to have multiple FDA-approved products on the market for treatment of life-threatening food allergies and will have options to present to our patients. As we move into this next phase of our practice, we will need to consider meaningful endpoints for our patients (e.g., likelihood of inducing desensitization versus sustained unresponsiveness, the relevance of various threshold changes induced by therapy, effects on quality of life, etc.). This review provides a comprehensive overview of the currently published literature and will prepare the practicing allergist for a thoughtful discussion with their patients and colleagues on the most recent developments in the field.

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References and Recommended Readings

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Correspondence to J. Andrew Bird M.D..

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Conflict of interest

Tiffany J. Lieu declares no conflict of interest.

J. Andrew Bird has received research support from Aimmune Therapeutics, DBV Technologies, and Food Allergy Research and Education. He is on the speaker’s bureau for Nutricia North America, Aimmune Therapeutics, and DBV Technologies. He has received consulting fees from Wedbush Securities.

Human and animal rights and informed consent

With regard to the authors’ research cited in this paper, all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. In addition, all applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

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This article is part of the Topical Collection on Specific Immunotherapy

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Lieu, T.J., Bird, J.A. Oral Immunotherapy, Sublingual Immunotherapy, or Epicutaneous Immunotherapy: Which Is the Right Solution?. Curr Treat Options Allergy 4, 1–13 (2017). https://doi.org/10.1007/s40521-017-0116-6

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Keywords

  • Food allergy
  • Immunotherapy
  • Oral immunotherapy
  • Sublingual immunotherapy
  • Epicutaneous immunotherapy
  • Desensitization