What is oit?
Oral immunotherapy (OIT) is an emerging treatment for food allergies where the patient consumes small amounts of an allergenic food, gradually building up a tolerance. The goal of OIT is to reduce the risk of a life-threatening reaction due to accidental exposure, and not necessarily to “cure” a patient of their allergy.
Oral immunotherapy involves giving patients with food allergy small amounts of the food to which they are allergic, and then slowly increasing this to a maintenance dose, usually a small amount of the food that is taken every day.
Recently published research(1) has demonstrated the relative safety of peanut oral immunotherapy (P-OIT) for a large group of preschool-aged children (less than 5 years of age) when offered as routine treatment in a hospital or clinic rather than within a clinical trial.
Should I start OIT outside of a clinical setting?
No, OIT should only be started in the presence of a trained allergist within a clinical setting. Recent data(1) demonstrates that the treatment is safe in preschoolers, and can be offered to families of preschool children with peanut allergy who ask for it. There is still risk of an allergic reaction, including anaphylaxis, during OIT which is why we strongly recommend against patients starting OIT at home, without adequate counselling.
Is my child, or am I, a candidate for OIT?
Pre-school aged children (less than 5 years of age) with a confirmed peanut allergy show the highest rate of success with OIT and are currently given the highest priority. Currently, OIT has shown to be less promising, with a greater risk of side effects, in children over 5 and adults, and is currently considered on a case by case basis for non pre-school aged patients. The science around OIT is rapidly evolving and this may change in the future with additional studies and resources.
Do Dr. COok and Dr. Cameron OFFER P-OIT / OIT?
Yes, both allergists offer P-OIT/OIT at their clinic in Victoria, BC.
Is OIT available for other foods?
Dr. Cook and Dr. Cameron do offer OIT for other foods, although the evidence for safety and efficacy is less robust than with peanut. Generally a decision to start OIT for other foods is made on a case by case basis, and can be limited by whether those foods are available in a form suitable for OIT.
How do I start OIT?
As Allergists are considered specialists in BC, a referral is needed from your primary care provider (family doctor or walk in clinic) before an appointment at the Allergy Clinic can be booked. Once the referral has been received, you will be placed on the clinic wait list (wait times are listed here). When an appointment time is available we will then contact you to setup an initial appointment to further determine whether you or your child are a suitable candidate for OIT.
What does an OIT program look like in practice?
The first step is to confirm the presence of food allergy, based on a combination of your history (what happens when a food is eaten), testing (skin prick testing, serum IgE testing). Sometimes, this means that we have to do an oral food challenge, where the food is eaten in the clinic setting to see whether there is a reaction.
If you and the physician decide that OIT is the right therapy, we book 8-10 visits, each 2 weeks apart. At each visit, the dose of the food protein is administered, and you will be observed in the office for 60 minutes. The same dose is then given daily at home for the next 2 weeks, at which time you return to the clinic for the next dose increase. After one year at maintenance dosing, you return to the clinic for repeat assessment with testing and an oral food challenge to a larger amount of the food.
oit Resources
See the clinic resources page here