2025 Volume 39 Issue 1 Pages 42-47
Although some reports have been published that present real-world oral immunotherapy (OIT) data on the use of the peanut OIT drug PALFORZIA®, these studies are difficult to reference in Japan because the symptom-provoking threshold has not been confirmed by oral food challenge (OFC) before OIT. A total of 259 patients (including participants of slow low-dose OIT (SLOIT) trial and excluded patients due to too severe) diagnosed with a severe allergy (symptom-provoking cumulative dose of boiled egg whites, udon noodles < 8.7 g, or milk < 8.7 mL) were enrolled in this analysis. We surveyed the desensitized amount of antigen approximately nine years after the OFCs. The number of patients who achieved full-dose desensitization (one hen's egg, 200 mL milk, and 200 g udon noodles) was 94/148 (63.5%) for hen's eggs, 31/60 (51.7%) for cow's milk, and 40/51 (78.4%) for wheat. Among them, lower proportions of patients whose allergies were initially considered too severe (hen's eggs 56.3%, milk 27.3%, and wheat 66.7%), those who initially did not choose SLOIT (hen's eggs 51.7%, milk 33.3%, and wheat 60.0%), and those who initially chose SLOIT but could not adhere to the planned regimen (hen's eggs 55.6%, milk 44.4%, and wheat 63.6%) achieved full-dose desensitization. Exercise-induced allergic reactions on desensitization were observed in 1/94 patients (1.1%) with hen's eggs, 6/31 (19.4%) with milk, and 8/40 (20%) with wheat.
