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Codfish Oral Immunotherapy in Children Aged 2-10: Randomized Placebo-Controlled Study.
Agnes Sze-Yin Leung1,2, Yanjun Gu1, Ann Wing-Shan Au1
1Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Allergy
|February 18, 2026
Summary
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.
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.
