Efficacy and Safety Balance of Oral and Sublingual Immunotherapy in Food Allergy

Abstract

During recent years, much research has been conducted on oral and sublingual immunotherapy in food allergy. Although efficacy has been shown for this treatment in terms of desensitization, long-term efficacy with regard to tolerance development is not yet proven. More importantly, safety remains a major issue. Although immunotherapy is already performed routinely in some countries, we currently do not recommend this therapeutic approach outside clinical trials. There have been only five randomized placebo-controlled trials but more than 34 reviews on oral immunotherapy in food allergy, indicating that more research is needed. Therefore, the current option for patients with food allergy remains avoidance of the offending food, and because of the constant risk of accidental exposure, patients are advised to use auto-injectable epinephrine in the case of anaphylactic reactions.