Efficacy and safety of low- and high-dose slow oral egg immunotherapy for hen's egg allergy: Single-center non-inferiority randomized trial.

Abstract

BACKGROUND:

Low-dose oral immunotherapy (OIT) is a safe treatment for hen's egg allergy; however, comparison of its therapeutic effects with those of high-dose OIT has not been reported.

OBJECTIVE:

To compare the efficacy of low- and high-dose boiled egg-white (EW) OIT for hen's egg allergy.

METHODS:

Patients with hen's egg allergy were randomly assigned to two groups: OIT using hard-boiled EW with a maximum maintenance dose of 2 and 20 g in the low-dose (L-D) and high-dose (H-D) groups, respectively. The intake dose was ingested twice a week, increased by approximately 20% per week until reaching the target maintenance dose (2 or 20 g hard-boiled EW), and maintained thereafter according to the schedule. The threshold was confirmed via oral food challenge (OFC) after 6 months, and the difference in the proportion of subjects passing the exit OFC between groups was evaluated.

RESULTS:

Fifty-two patients (L-D, n = 23; H-D, n = 29) were enrolled. Thirty-three patients (L-D, n = 17; H-D, n = 16) completed the 6-month OIT and underwent an exit OFC. In total, three (L-D, 3/17; H-D, 3/16) patients in each group tested negative for an exit OFC with a 20-g reactive dose (p = 1.000). EW-specific IgE levels in both groups decreased significantly after OIT (L-D, p < 0.001; H-D, p = 0.002).

CONCLUSIONS:

A threshold-elevating effect was observed in the L-D group, not inferior to that in the H-D group. Low-dose OIT may be appropriate to treat hen's egg allergy for the first 6 months.

• Authors: Yuri Takaoka, Yoichi M Ito, Junko Kumon, Tomohiro Yamaguchi, Rumi Ueno, Yuki Tsurinaga, Tamana Nakano, Yohei Fukasawa, Amane Shigekawa, Yukinori Yoshida, Makoto Kameda, Satoru Doi
• Journal: Asian Pacific journal of allergy and immunology (Asian Pac J Allergy Immunol) (Apr 17 2023) ISSN: 0125-877X [Print] Thailand
• PMID: 37061933 (Publication Type: Journal Article)