Live Presentation
Speak with Dima Elgendy about her practicum on January 31st from 4:30-5:00pm via this .
Video Presentation
View Dima Elgendy 's poster presentation in this video recording:Â
Abstract
Food allergies and anaphylaxis are pervasive public health issues among Canadian children. Past management of food allergies relied on allergen avoidance and epinephrine injections for accidental reactions. Nonetheless, the majority of children today can be desensitized through oral immunotherapy (OIT). However, a major limitation of current OIT protocols is the risk of anaphylaxis. Thus, our team aimed to develop modified OIT protocols to promote a safer approach to pediatric food allergy desensitization, without compromising effectiveness. Â
Children <12 years old with a sesame (18), peanut (80), and/or tree nut (28) allergy diagnosis, based on patient history and a positive skin prick test, were recruited at hospital and community-based allergy clinics. Upon initial visit, a dose of 5-12mg of sesame, peanut, or tree nut protein was introduced to the patient after obtaining guardian consent. Patients then continued the dose for 2-5 weeks at home, filled out a symptom diary, and returned to the clinic for up-dosing until a pre-determined maintenance endpoint was reached. Adverse events during the desensitization protocol were classified as mild, moderate, or severe. Â
Patient demographics (age/sex), comorbidities (asthma/eczema/co-allergies), and the safety of our modified OIT protocols (frequency/severity of adverse reactions at-home and in-clinic) were analyzed using descriptive statistical methods. Based on the most recent analyses conducted as of August 2021: among 16,264 total intake doses of sesame (1,895), peanut (11,105), or tree nut (3,264), 160 cases of mild non-anaphylactic allergic reaction, 2 cases of moderate non-anaphylactic allergic reaction, 10 cases of mild anaphylaxis, and 3 cases of moderate anaphylaxis were reported.Â
Non-anaphylactic allergic reactions occurred in only 1% of doses and anaphylaxis occurred in only 0.08% of doses. Therefore, we conclude that this preliminary data supports the safety of our modified OIT desensitization protocols against sesame, peanut, and tree nuts in real-world pediatric clinical practice. However, these results can only serve as an indicator of the modified protocol’s relative safety. Further analysis of efficacy is required. If future analyses also provide reassuring results, it is strongly recommended that our modified OIT protocol be implemented in clinical practice in order to improve the health of Canadian children with food allergies.Â