Abstract
Rush oral immunotherapy (rush OIT) for severe food allergy has several benefits compared with slow OIT since it has ample evidence in efficacy and safety. The factors that determine the effects of allergen immunotherapy are dosing and frequency of allergen administration and length of the course. Several randomized controlled trials (RCTs) have proved that higher and frequent dosing can be employed by utilizing refractory period of IgE-mediated reaction and ultimately result in full desensitization status in short period. On the contrary, there has been little evidence in efficacy of slow OIT since controlled trial is difficult to perform because of long treatment period and natural outgrow process over the long period confounds the study results. In addition, rush OIT may be safer than slow OIT because the former treatment is performed in hospital settings under intensive medical supervision and the latter is done at home without supervision. We have performed RCTs of rush OIT for severe egg and milk allergy and clearly proved the efficacy not only in desensitization/tolerance induction but also in QOL. Therefore rush OIT is indispensable treatment for children with severe food allergy.
