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Summary
Immunotherapy (“desensitisation”) to switch off food allergy is an active area of research, but is not yet ready for routine clinical practice. A number of small human studies or oral immunotherapy have been published in the last 10 years, attempting to switch of allergy to dairy, egg and peanut by introducing small amounts of food, and increasing the dose over time.

These are hospital based trials for safety reasons, as many on these studies will have allergic reactions as the dose is being increased, some drop out due to side-effects, and others will have unexpected allergic reactions, such as if they eat the allergic food and then exercise, or have an infection, or forget to take their dose for a few days.  There is also an ongoing need to eat the food most days to maintain tolerance in most trials and reports of eosinophilic oesophagitis developing in some cases. The quality of life appears to be lower and frequency of side-effects higher in those undertaking immunotherapy compared to those simply avoiding their known allergen.

This is an exciting area of research but hospital based nature of the studies (for safety reasons) precludes our ability to incorporate this into routine clinical practice at this time.  Food patch immunotherapy (without the risk of eating the food) is also under trial. Long term, one needs a safe process that can be done as an outpatient. Time will tell.

See also ASCIA statement: https://www.allergy.org.au/patients/allergy-treatment/oral-immunotherapy-for-food-allergy

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Last reviewed 9 June 2020