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Codfish Oral Immunotherapy in Children Aged 2-10: Randomized Placebo-Controlled Study.

Agnes Sze-Yin Leung^1,2, Yanjun Gu¹, Ann Wing-Shan Au¹

¹Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.

|February 18, 2026

Summary

This summary is machine-generated.

Codfish oral immunotherapy (OIT) significantly improved desensitization in children with fish allergy. While sustained unresponsiveness was limited, OIT showed safety and reduced cross-reactivity to other fish.

Keywords:

allergen immunotherapy codfish allergy desensitization therapy oral immunotherapy randomized controlled trial

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Area of Science:

Allergy and Immunology
Pediatric Allergy
Food Immunotherapy

Background:

Dietary avoidance is the standard for managing fish allergy in children.
Assessing the efficacy of codfish oral immunotherapy (OIT) for desensitization and sustained unresponsiveness (SU) is crucial.

Purpose of the Study:

To evaluate codfish OIT's ability to induce desensitization and SU in children with fish allergy.
To compare OIT with placebo in a randomized, double-blind, controlled trial.

Main Methods:

A randomized, double-blind, placebo-controlled study involved 70 children (aged 2-10) reactive to codfish.
Participants received either codfish OIT or placebo for 52 weeks, followed by 8 weeks of avoidance.
Primary outcome was desensitization at 52 weeks; SU at 60 weeks was a secondary outcome.

Main Results:

43% of OIT participants achieved desensitization versus 11% in the placebo group (p=0.003).
SU rates were 23% for OIT versus 9% for placebo (p=0.332).
OIT reduced specific IgE, skin reactivity, and cross-reactivity to other fish, with good safety and mild reactions.

Conclusions:

Codfish OIT significantly enhances desensitization rates in children with fish allergy compared to avoidance.
While SU was limited, OIT is a safe option with potential to reduce allergic cross-reactivity to other fish species.