Learning More About Oral Immunotherapy for Food Allergy

Over the last decade, food allergies have been increasing at a staggering rate, with a 50% rise in prevalence among children alone.1 Peanut allergy is one of the most common food allergies, affecting more than 1.6 million children and teens in the U.S.2.3

Despite the significant, serious, and urgent need, the standard of care for patients with food allergy has remained strict avoidance of the allergen for centuries, and there were no U.S. FDA-approved treatments available until recently. 

Michael Manning, M.D., FAAAAI, FACAAI, has more than 20 years of experience helping patients and their families navigate living with food allergies (specifically focusing on peanut allergy). 

Here, the Arizona-based allergist shares with us his experience working with parents and children to help ease the many anxieties they face as a result of peanut allergies and explains how oral immunotherapy (OIT) for food allergy works.

Allergist Dr. Michael Manning shares his experience with oral immunotherapy.
Allergist Dr. Michael Manning  

What is OIT?

Dr. Manning: In the early 1900s, researchers discovered that giving food allergens orally in very small doses could result in gradual desensitization – a process that helps increase tolerance to the allergen. By 2010, several small studies had shown that people with food allergies could be desensitized to food allergens by consuming increasing amounts of the allergen over a period of months.

While not a cure for food allergies, OIT has since become a well-established therapeutic approach for many allergists to reduce the risk of allergic reactions – in combination with avoidance of the allergen - to help provide peace of mind for some of their patients and their families. 

If OIT has been around for so long, why have allergists and their patients continued to rely on strict avoidance to prevent an allergic reaction?

Dr. Manning: While some allergists around the globe have already been using OIT in their clinics, others preferred not to offer OIT to their patients as it was seen as risky to do so without clinical trials and an FDA-approved product. The approach further lacked consistency and precision due to variabilities in the food and the amounts used. Also, given there was no structured protocol in place for allergists or patients, it was difficult to reproduce positive results or scale the therapy to treat many more patients. 

What is your direct experience with OIT?

Dr. Manning: I have been practicing OIT for five years, and am excited to see that today, more allergists may be able to offer their patients OIT. Parents and their peanut-allergic children should talk to their allergist to determine if FDA-approved OIT is an option for them. 

How do I know if my child is a good candidate for OIT?

Dr. Manning: Families who are interested in OIT should do their research, speak to other families who have gone through the treatment and, importantly, speak to their allergist, to make an informed and shared decision on whether OIT is right for them. While no one treatment is right for everyone, it is important to weigh all available options and to have those discussions to align on what will work best for their family to manage peanut allergy. 

This article was sponsored by Aimmune Therapeutics. Dr. Michael Manning is a paid advisor to Aimmune Therapeutics.

1Food Allergy Research Foundation (FARE): Facts and Statistics. Retrieved July 1, 2020, from https://www.foodallergy.org/life-with-food-allergies/food-allergy-101/facts-and-statistics
2 United States Census Bureau Quick Facts (2015 estimates).
3Gupta R, Warren C, Blumenstock J, et al. OR078 The Prevalence of Childhood Food Allergy in the United States: An Update. Ann Allergy Asthma Immunol. 2017;119(5 Suppl): S11.