December 07, 2018
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Wheat oral immunotherapy helps young patients with wheat allergy

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Anna Nowak-Wegryzn
Anna Nowak-Wegrzyn

Low-dose vital wheat gluten oral immunotherapy induced desensitization after 1 year of treatment in patients with wheat allergy, according to findings recently published in the Journal of Allergy and Clinical Immunology.

“Wheat is one of the most common food allergens in children. The only current ‘treatment’ for them is to avoid foods with wheat, which is difficult due to its ubiquitous presence in the American diet. Therefore, we need novel strategies to address wheat allergy,” Anna Nowak-Wegrzyn, MD, PhD, professor of pediatrics at Icahn School of Medicine at Mount Sinai told Healio.com/Family Medicine.

Researchers conducted a double-blind, placebo-controlled food challenge, then randomly assigned 46 patients with wheat allergy (median age, 8.7 years) in a 1:1 ratio to receive low-dose wheat gluten oral immunotherapy escalating to 1,445 mg of wheat protein biweekly or placebo.

Researchers found that after 52 weeks of treatment, 52% of those with wheat allergy were able to eat a cumulative dose of 4,443 mg of wheat protein without an adverse event.

Nowak-Wegrzyn said she was encouraged by the results but was not ready to say they should be implemented in clinical practice.

“This study was small but was designed very rigorously and included the patients with very severe wheat allergy. There is hope that with more research we will be able to provide a treatment that will reduce the risk of life-threatening allergic reactions caused by small amounts of wheat to keep patients with severe wheat allergy safe and with longer duration of treatment, allow them to eat and enjoy regular wheat products in their daily diet,” she said in the interview.

Future studies will also attempt to establish the “optimal maintenance dose and duration of oral immunotherapy” for young patients with wheat allergy, according to a press release issued by the Icahn School of Medicine at Mount Sinai. – by Janel Miller

Disclosures: Nowak-Wegrzyn reports being employed by the Icahn School of Medicine; receiving grants from Astellas Pharma, DBV Technologies, Nestle, and Nutricia; receiving royalties from UpToDate; serving on advisory boards for ALK-Abelle, the Gerber Institute, Merck and Sanofi Aventis; and is the deputy editor for the Annals of Allergy Asthma and Immunology. Please see the study for all other authors’ relevant financial disclosures.