Oral immunotherapy has been an effective way to treat peanut and egg allergies. Can baked egg therapy improve food allergy outcomes in children who can tolerate baked eggs?
Eggs are one of the big 8 food allergens and much like with peanuts, using oral immunotherapy has been used to achieve desensitization and sustained unresponsiveness. An investigation in the Journal of Allergy and Clinical Immunology looked at the potential benefits of baked egg therapy for egg allergy, which the researchers noted had not been well studied previously.1
The researchers enrolled children aged 3 to 16 years who were baked egg-tolerant but unbaked egg reactive. Each participant was randomized to receive 2 years of treatment with either egg oral immunotherapy or baked egg therapy. They administered double-blind, placebo-controlled food challenges following 1 and 2 years of treatment to assess for desensitization. Another challenge was administered after 2 years of treatment, followed by 8 to 10 weeks without the treatment, to assess sustained unresponsiveness. Additionally, some children who were baked egg-reactive were given egg oral immunotherapy and given identical double-blind, placebo-controlled food challenges to be used as a comparator group.
A total of 50 children were included in the study. The investigators found that sustained unresponsiveness occurred in 3 of the 27 children who were assigned to the baked egg therapy group versus 10 of the 23 participants who had been assigned to receive egg oral immunotherapy (P = .009). Within the comparator group, 7 of the 39 children were able to achieve sustained unresponsiveness. The dosing symptom frequency was similar for both baked egg therapy and egg oral immunotherapy among the children who were baked egg tolerant, but were more frequent in the comparator group. The investigators found that egg white–specific immunoglobulin E skin testing and basophil activation decreased in a similar fashion following baked egg therapy and egg oral immunotherapy.
The researchers concluded that treatment of unbaked egg allergy with oral immunotherapy was much more likely to help a child achieve sustained unresponsiveness than baked egg therapy.
1. Kim E, Perry T, Wood R, et al. Induction of sustained unresponsiveness after egg oral immunotherapy compared to baked egg therapy in children with egg allergy. Journal of Allergy and Clinical Immunology. 2020;146(4):851-862.e10. doi:10.1016/j.jaci.2020.05.040