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what is oral immunotherapy

What is oral immunotherapy (OIT)?

Oral immunotherapy (OIT) is a process that regularly exposes the patient to increasing amounts of the foods they are allergic to, with the goal of desensitizing the body and protecting against anaphylaxis due to accidental exposures. Research over the last two decades supports the safety and efficacy of OIT for patients with single and multiple food allergies.

Where can I find additional publications and data on OIT?

For more background on oral immunotherapy, we recommend the following published studies and meta-analysis:

Which allergens can be treated with OIT?

IgE-mediated food allergies can be treated with oral immunotherapy and multiple allergens can be treated together. Our allergists work with each patient to weigh the benefits and the burden of the treatment for each allergen. Below are results of clinical studies and relevant reviews for treatment of specific food allergens. 

Peanut

Wheat

Cow’s Milk

Egg

Tree Nuts (Walnut, Pecan, Cashew, Pistachio, Hazelnut, Almond, Brazil Nut, Macadamia) 

Fish & Shellfish

Sesame

Is OIT covered by insurance?

Most of the services we provide are covered by insurance. For example, our initial diagnostic visits and follow up office visits are typically covered. If we determine that oral immunotherapy is the right treatment plan for you, office visit costs will be covered by your insurance, but there is a one-time program fee — only applicable to oral immunotherapy patients — that is considered a non-covered service and therefore not billable to insurance. Payment plans are available for the program fee and it is often FSA- or HSA-eligible. If you are considering treatment, please call us for more details.

Do you offer Xolair in conjunction with OIT?

Xolair (omalizumab) is an anti-IgE monoclonal antibody that works by inhibiting the allergic reaction process. It is FDA approved for use in children over age 6 with asthma and in children over age 12 with chronic urticaria (hives). At Latitude, we offer Xolair in conjunction with OIT to increase safety for some patients. Xolair has been granted Breakthrough Therapy Designation for the prevention of severe allergic reactions to food allergy by the FDA, but this is currently an off label usage and is often not covered by insurance. 

For more background on oral immunotherapy with anti-IgE Xolair (omalizumab), we recommend the following published studies and meta-analysis:

What types of patients are good candidates for OIT?

We look forward to partnering with you on your patient’s care. While there are some underlying medical conditions that may preclude treatment, most patients can be treated with oral immunotherapy. We provide OIT for patients as young as 12 months old and adults. When we discuss the benefits and risks with a patient and their family, we address the following: 

  • Clarifying diagnosis to verify the current list of allergies
  • Reaction history
  • Emotional readiness of the patient and family
  • Ability to incorporate therapy into family’s lifestyle
  • Expectations and measures of success

Please reach out to our clinical team at (650) 466-6224 if you have a question about a specific patient profile. 

Do you treat multiple allergens simultaneously?

Yes, we treat multiple food allergies at the same time. For more background on oral immunotherapy for multiple foods — with and without the off-label use of anti-IgE Xolair (omalizumab) as an adjunct — we recommend the following published studies and meta-analysis:

Is OIT safe?

Thousands of patients have safely completed oral immunotherapy around the world. We have specific protocols in place to increase safety in the office and at home during OIT, but it is possible to have an allergic reaction while going through OIT.

For more information about the risks and benefits of OIT, we recommend the following published studies and meta-analysis:

Is OIT a cure?

OIT is not a cure. It is a desensitization. In order to maintain desensitization, a patient needs to continue to eat the foods they have been desensitized to on a regular basis.

Research shows that OIT is approximately 85% effective when supervised by an expert care team who specialize in food allergy treatment. At Latitude our success rate is in line with this. While there are a small number of clinical reasons a patient may need to stop therapy, the remaining 15% of patients primarily pause treatment due to the time commitment or other lifestyle demands.   

For more background on the long-term impact of oral immunotherapy, we recommend the following published studies and meta-analysis:

How is Latitude different from a traditional allergist’s practice?

At Latitude, our clinics are 100% focused on food allergy. Our board-certified allergists are all specially trained and deeply experienced in food allergy treatment and care. And our unique clinical model provides quick access for your patients to important testing and treatment options, including oral food challenges.

  • We are affiliated with UCSF Benioff Children’s Physicians, a world-class network.
  • Food Challenge Availability — our clinical model enables us to offer quicker access to food challenges, often within less than two weeks of an initial testing appointment.
  • We offer treatment with oral immunotherapy (OIT) for single and multiple foods, with and without the use of Xolair (omalizumab).
  • Our treatment program is built on evidence-based protocols and important elements to ensure safety and compliance, including our Remote Therapeutic Monitoring (RTM) system, via a patient mobile App, that allows for real-time clinical monitoring of our OIT patients’ at-home dosing.
  • Our team of Patient Care Coordinators (PCC) — parents with personal experience with food allergies and OIT — support patients and their families. 

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