OIT, SLIT, SCIT and Biologic Treatments

Food Allergy Treatment Options

We are able to offer different treatment options for food allergy. A shared decision making process is undertaken before any choice is made. Clear goals need to be identified before commencing what can be a long term journey for patients and families.

Examples of therapies that we offer include:

Avoidance and Emergency Training
This baseline strategy focuses on strict dietary allergen exclusion alongside proactive emergency preparation. We provide families with a bespoke, written Emergency Action Plan detailing exactly how and when to administer emergency medications, including adrenaline auto-injectors or intranasal adrenaline devices. This has been the default management option for years and remains so in most allergy clinics be they NHS or Private based. The downside of this approach is that many food allergies will not be outgrown, and IgE levels rise into the teenage years, so 'kicking the treatment can' down the road can result in heightened reactivity i.e. prone to more severe reactions and lower-dose reactivity.

Oral Immunotherapy (OIT)
Conducted safely under specialist supervision within our Allergy Centre of Excellence (ACE), OIT involves consuming tiny, gradually increasing amounts of the allergen to desensitise the immune system. This provides ‘bite-proof’ protection for most children. However, in younger children, OIT may facilitate the complete resolution of the allergy. The earlier in life this is commenced, the better the outcomes, and the easier the treatment journey. The specific regimen and the number of allergens we can treat simultaneously are age and allergen specific. More comprehensive details about these protocols and associated pricing plans are available on the ACE website. At least 8 ACE visits, spaced at least 2 weeks apart, will be required (longer for some allergens and depending on your OIT journey and symptoms). Walnut OIT will usually also provide protection against pecan allergy; cashew OIT will usually provide protection against Pistachio allergy.

Anti-IgE injection therapy - Mono-therapy
Anti IgE products (omalizumab) is a monthly (two weekly for some patients) biologic injection that works by intercepting and blocking IgE antibodies before they can trigger an allergic reaction. This therapy can be used entirely on its own for as long as a family desires. It is a highly flexible option, frequently chosen to provide a temporary safety net to cover high-risk periods, such as international travel or major life events. At least 2 jabs are required, every 4 weeks. Advantages are that this ‘IgE sponge’ is not allergen specific and will, to a high degree, cover all foods and aero-allergens. Downsides are that the medication will wear off when treatment is stopped. We can teach most families/patients to self-inject if they are willing. This medication is not approved for the treatment of Food Allergy in the UK, it is approved for this indication by the FDA.

Combined Anti-IgE and Multi-Allergen OIT at ACE
This advanced, accelerated protocol begins with three months of standalone Anti-IgE injection therapy to build an initial layer of immune protection. Following this priming period, we commence a comprehensive multi-allergen OIT regimen targeting up to four allergens simultaneously, whilst the regular Anti-IgE injections continue alongside to suppress adverse reactions. The advantage of this intense regimen is that more food allergens can be simultaneously treated in older or higher risk individuals. A disadvantage is that we cannot predict the level of ongoing tolerance once the anti-IgE therapy is stopped, and the blocking effect wears off. If needed, we may need to reduce the maintenance doses at that stage.

Sublingual Immunotherapy (SLIT) to food allergens
Please note that this program has not yet commenced at ACE but will hopefully commence later this year. SLIT involves placing liquid allergen drops under the tongue to build tolerance. SLIT allergen doses are lower than those used in traditional OIT. Compared with conventional OIT, this method imposes fewer lifestyle restrictions e.g. exercise restrictions, and is associated with fewer adverse effects, though it may ultimately achieve a lower overall level of allergen tolerance.

Immunotherapy for aeroallergens (SLIT / SCIT)

Sublingual and subcutaneous immunotherapy can reduce hayfever and airborne-allergy symptoms over time, and may help children whose allergic rhinitis affects sleep, school and quality of life.These therapies cover all common aero-allergens.

SCIT injections take place within our Allergy Centre of Excellence service and are available to grass and tree pollen.