Egg OIT in clinical practice (SEICAP II): Maintenance patterns and desensitization state after normalizing the diet

Area of Science:

• Allergy and Immunology
• Clinical Trials
• Pediatric Medicine

Background:

• Oral immunotherapy (OIT) is a treatment for food allergies, but optimal maintenance strategies post-treatment are unclear.
• Maintaining desensitization after OIT requires understanding appropriate egg consumption levels and patterns.

Purpose of the Study:

• To compare two OIT maintenance patterns using pasteurized egg white (PEW).
• To evaluate the impact of varying egg consumption on sustained desensitization after OIT cessation.

Main Methods:

• A multicenter, randomized controlled trial involving 101 children with confirmed egg allergy.
• Patients received either an egg-free diet (control) or OIT with PEW, followed by daily (AG) or every-other-day (BG) maintenance.
• Double-blind, placebo-controlled food challenges (DBPCFC), adverse reactions, and immune markers were assessed over 12 months post-OIT.

Main Results:

• 84.21% of OIT patients achieved desensitization by 12 months, compared to 16% in the control group.
• Daily maintenance (AG) showed higher completion rates (93.75%) and sustained desensitization (93.1% at 18 months) than every-other-day (BG).
• 96% of patients consuming at least two egg servings weekly maintained desensitization at 18 months, with 97.43% at 24 months.

Conclusions:

• Daily OIT maintenance with PEW is more effective, safer, and better adhered to than less frequent patterns.
• Consuming at least two servings of eggs per week is sufficient to maintain desensitization after completing a year of OIT.