A 5-Year Summary of Real-Life Dietary Egg Consumption After Completion of a 4-Year Egg Powder Oral Immunotherapy (eOIT) Protocol

To assess long-term outcomes of children treated with egg oral immunotherapy (eOIT).

Subjects who participated in the original clinical trial (N = 55), with a median age of 12.7 years at the initiation of the follow-up period.

After completing up to 4 years of eOIT, those subjects who achieved sustained unresponsiveness (SU) were instructed to introduce dietary egg ad libitum. Subjects who had not achieved SU introduced dietary egg on a case-by-case basis. Dietary egg was categorized into less-allergenic baked egg products such as cakes, cookies, and waffles versus lightly cooked concentrated egg products such as scrambled egg or French toast. A 25-question long-term follow-up questionnaire (LFQ) was administered annually for 5 years after completion of the original clinical trial. Questions focused on the consumption of concentrated egg and baked egg products, quantity and frequency of egg ingestion, and safety parameters.

Forty-nine of the 55 of the children in the original trial completed at least one follow-up questionnaire, and 43 completed the 5 year FU (including 32/40 who received eOIT and 11/15 who had received placebo). Thirty of the 32 who had received eOIT were able to introduce baked egg, and 23 were further able to introduce concentrated egg into the diet. Only 2 subjects who had received eOIT were fully restricting egg 5 years after completion of eOIT compared with 4 of the 11 subjects who received placebo.

In the majority of children with egg allergy, treatment with eOIT resulted in successful introduction of egg lasting up to 5 years after completion of therapy.

Although there are now hundreds of studies on the treatment of food allergy with OIT, there are relatively few focused on long-term outcomes, which one can argue are really all that matters. This is especially true for a food like egg that is such a common component of the childhood diet. This study provides a reassuring and optimistic view of the long-term outcome of OIT for children with egg allergy.