Dr. Windom gave a lecture on Food Allergy Treatment at the South Carolina Allergy Society’s annual meeting in Charleston, SC, March 17-19, 2017. No one is currently offering food oral immunotherapy (OIT) in South Carolina so the society wanted to learn from Dr. Windom’s experience with this novel form of treating patients with serious food allergies.
The lecture was titled, Food Oral Immunotherapy in Clinical Practice. The two major points were:
There are over 20 published studies on oral immunotherapy (OIT) in the medical literature since 2004, consistently showing the safety and efficacy of desensitizing highly allergic individuals to various foods. The foods have included peanut, milk, egg, wheat, and tree nuts. The dosing protocols used in the studies are very similar to one another, involving a multi-dose escalation day one, single dose buildup visits, and a maintenance phase. The schedule and doses used in the research studies has been adopted for clinical use in clinics like Windom Allergy in Sarasota. The success of OIT research has not only led allergists to start offering treatment to their patients, but has spawned the development of two peanut products, one a capsule and the other a patch, seeking FDA approval at a cost of over $100 million each.
Oral food challenges are the gold standard for determining true food allergy. But what about allergy skin or blood testing? These are both available and routinely performed, but unfortunately they are often overly sensitive. That means a positive test does not always mean you are really allergic. In fact, a positive test is incorrect 50% of the time. With that knowledge, most allergists now offer oral food challenges in the office to see how you tolerate a food that you haven’t eaten in the last few years and the test is not hugely positive. Gradually increasing amounts of the foods are given 20-30 minutes apart until you react or you reach the top dose. These challenges are safe and are always highly informative. The best outcome can be a negative challenge, proving you can safely eat the food. If you do have a reaction, runny nose, itching, hives, stomach pains, or vomiting, then your options are ongoing avoidance or oral immunotherapy. Both food challenges and oral immunotherapy are routinely performed at Windom Allergy.