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Evidence summaries

Oral Immunotherapy for Egg Allergy

Oral immunotherapy with daily egg protein may be effective for egg allergy in children compared with placebo or avoidance diet. However, data on long-term effect on tolerance are insufficient. Level of evidence: "C"

Comment: The quality of evidence is downgraded by study limitations (lack of blinding) and by imprecise results (small trials and few patients).

Summary

A Cochrane review [Abstract] 1 included 4 studies with a total of 167 subjects, all of whom were children (aged 4 to 15 years). One study used a placebo and 3 studies used an avoidance diet as the control. Each study used a different oral immunotherapy (OIT) protocol. 39 per cent of OIT participants were able to tolerate a full serving of egg compared to 11.9% of the controls (RR 3.39, 95% CI 1.74 to 6.62). 40 per cent of OIT participants could ingest a partial serving of egg (1 g to 7.5 g; RR 5.73, 95% CI 3.13 to 10.50). 69 per cent of the participants presented with mild-to-severe adverse effects during OIT (RR 6.06, 95% CI 3.11 to 11.83). Five of the 100 participants receiving OIT required epinephrine. The studies were small and the quality of evidence was low. Current evidence suggests that OIT can desensitize a large number of egg-allergic patients, although it remains unknown whether long-term tolerance develops.

Clinical comments

Note

Date of latest search: 5 December 2013

References

  • Romantsik O, Bruschettini M, Tosca MA et al. Oral and sublingual immunotherapy for egg allergy. Cochrane Database Syst Rev 2014;(11):CD010638. [PubMed]

Primary/Secondary Keywords