Oral Immunotherapy for Food Allergy: A Spanish Guideline. Immunotherapy Egg and Milk Spanish Guide (ITEMS Guide). Part I: Cow Milk and Egg Oral Immunotherapy: Introduction, Methodology, Rationale, Current State, Indications, Contraindications, and Oral Immunotherapy Build-up Phase
***Martorell A1, **Alonso E2, **Echeverría L3, **Escudero C4, **García-Rodríguez R5, *Blasco C6, *Bone J7, *Borja-Segade J5, *Bracamonte T3, *Claver A8, *Corzo JL9, *De la Hoz B10, *Del Olmo R11, *Dominguez O12, *Fuentes-Aparicio V13, *Guallar I7, *Larramona H14, *Martín-Muñoz F15, *Matheu V16, *Michavila A17, *Ojeda I18, *Ojeda P18, *Piquer M12, *Poza P16, *Reche M19, *Rodríguez del Río P4, *Rodríguez M20, *Ruano F21, *Sánchez-García S4, *Terrados S22, *Valdesoiro L14, *Vazquez-Ortiz M23
Expert panel selected from members of the Spanish Society of Pediatric Allergology, Asthma and Clinical Immunology (SEICAP) and the Spanish Society of Allergology and Clinical Immunology (SEAIC)
***Coordinator. **Scientific committee (in alphabetical order). *Members (in alphabetical order)
1Department of Allergology, University General Hospital, Valencia, Valencia, Spain
2Department of Pediatric Allergy, Gregorio Marañón Hospital, Madrid, Spain
3Department of Pediatric Allergy, Severo Ochoa University Hospital, Leganés, Spain
4Department of Pediatric Allergy, Niño Jesús University Children’s Hospital, Madrid, Spain
5Department of Allergology, University General Hospital, Ciudad Real, Spain
6Department of Pediatric Allergy, Vall d’Hebron Hospital, Barcelona, Spain
7Department of Pediatric Allergy, Miguel Servet University Hospital, Zaragoza, Spain
8Quirón Dexeus University Hospital, Barcelona, Spain
9Department of Pediatric Allergy, Carlos Haya University Hospital, Málaga, Spain
10Department of Allergology, Ramón y Cajal Hospital, Madrid, Spain
11Department of Pediatric Allergy, University Hospital, Móstoles, Spain
12Department of Pediatric Allergy, San Joan de Deu Hospital, Barcelona, Spain
13Department of Allergology, San Carlos Clinic Hospital, Madrid, Spain
14Department of Pediatric Allergy, Parc Taulí University Hospital, Sabadell, Spain
15Department of Allergology, La Paz Children’s Hospital, Madrid, Spain
16Allergology Unit-North Chest Hospital, Santa Cruz de Tenerife, Spain
17Department of Pediatric Allergy, General Hospital, Castellón, Spain
18Ojeda Clinic, Madrid, Spain
19Department of Allergology, Infanta Sofía Hospital, San Sebastián de los Reyes, Spain
20Department of Allergology, Alcorcón Foundation Hospital, Alcorcón, Spain
21Department of Allergy, Infanta Leonor Hospital, Madrid, Spain
22Department of Pediatric Allergy, Ramón y Cajal Hospital, Madrid, Spain
23Pediatric Allergy, Department of Medicine, Imperial College London, United Kingdom
Copublished in Allergologia et Immunopathologia
J Investig Allergol Clin Immunol 2017; Vol 27(4)
Introduction: Cow milk and egg are the most frequent causes of food allergy in the first years of life. Oral immunotherapy (OIT) has been investigated as an alternative to avoidance diets. No clinical practice guidelines on the management of OIT with milk and egg are currently available.
Objectives: To develop clinical guidelines for OIT based on available scientific evidence and the opinions of experts.
Methods: A review was made of studies published between 1984 and June 2016, doctoral theses published in Spain, summaries of communications at scientific meetings (SEAIC, SEICAP, EAACI, and AAAAI), and the consensus of opinion established by a group of experts from the scientific societies SEICAP and SEAIC.
Results: Recommendations were established regarding the indications, requirements and practical aspects of the different phases of OIT, as well as special protocols for patients at high risk of adverse reactions.
Conclusions: Clinical practice guidelines based on the consensus reached between Spanish experts are presented for the management of OIT with milk and egg.
Key words: Guide, Oral immunotherapy, Desensitization, Specific oral tolerance induction, Milk allergy, Egg allergy, Omalizumab, Sublingual immunotherapy