A safer way to treat kids who have food allergies
Mac-led research team behind new guidelines for oral immunotherapy
A kid that once would’ve gone into anaphylaxis upon eating a peanut may, with the gradual introduction of the allergen to their diet, be able to enjoy a peanut butter and jam sandwich.
This “amazing phenomenon” known as oral immunotherapy — in which a patient is given small amounts of an allergy-causing food over a period of time to build tolerance — has been around for decades, said pediatric allergy expert Douglas Mack.
But until now, there was no standardized way to prepare kids and their parents to administer and manage the treatment, which can include responding to allergic reactions and understanding patient comorbidities.
Mack, an assistant clinical professor at McMaster University, and a team of researchers have developed the first guidelines for doctors and families treating allergies with oral immunotherapy.
“Most people do not have any medical training,” Mack, the paper’s lead author, told The Spectator. “When we were looking at our practice, we realized the mistakes that parents made were not because they were not capable, but that we hadn’t really prepared them.”
In oral immunotherapy, doses are increased periodically at the clinic and then at home. Allergic reactions can occur, which is a risk many families aren’t equipped to deal with, he said.
The new guidelines released Monday, which Mack calls “useful and practical,” incorporate rules for clinicians and an education plan for families, which includes everything from parental supervision to information about additional health conditions that may make a patient ineligible.
“Any clinician can take this protocol and apply it to the patient that walks in the door,” Mack said.
The research also includes a consent form outlining risks, benefits, alternatives and challenges, the absence of which has been a “huge gap” in preparing families to administer the therapy, Mack said.
Ultimately, the goal is to help parents make the treatment, which has gained momentum in the last five or 10 years, “safer and more sustainable for them and their kids,” he said.
One of the strengths of the study is that it leans on observations from a panel of 36 experts in oral immunotherapy from around the world serving more than 14,000 patients, Mack said.
“This is not just what do I think, it’s what does the world think,” he said.