Division of Pediatric Allergy & Immunology, University of California San Diego, Rady Children's Hospital San Diego, San Diego, Calif.
Division of Pediatric Allergy & Immunology, University of California San Diego, Rady Children's Hospital San Diego, San Diego, Calif.
J Allergy Clin Immunol. 2021 Jan;147(1):1-13. doi: 10.1016/j.jaci.2020.11.011. Epub 2021 Jan 5.
In 2020, the first food allergy treatment, an oral immunotherapy (OIT) product for peanut allergy, was approved by the Food and Drug Administration, and a peanut epicutaneous immunotherapy patch was under review. As food allergy therapies become available and widespread, allergy offices will need to adjust practices to be able to offer their patients these new treatments. OIT is an intensive therapy that requires commitment from patients and their families, and open communication with the practice is paramount. OIT may not be the right therapy for every patient, and although identifying good candidates is still an area rich for research opportunity, experience from cohorts and clinical trials provides some insight. It is important to understand the scope of practice for each member of the OIT team based on state regulations for a particular location. Staffing and space will likely dictate how many patients at an individual office could be on active OIT at one time. Emergency medications, supplies, and protocols must be in place. Screening, scheduling, visit procedures, monitoring, home dosing, dose modifications, safety precautions, adverse reactions, and maintenance will be addressed in this article. Finally, adjunct therapies under investigation will be reviewed.
2020 年，首款食物过敏治疗药物——用于治疗花生过敏的口服免疫疗法（OIT）产品获得美国食品药品监督管理局（FDA）批准，同时一种花生贴皮免疫疗法贴片也正在审查中。随着食物过敏疗法的不断普及，过敏专科门诊需要调整治疗方案，以向患者提供这些新疗法。OIT 是一种强化疗法，需要患者及其家属的承诺，与诊所的开放沟通至关重要。OIT 可能并不适合每个患者，尽管确定合适的患者仍然是一个具有丰富研究机会的领域，但来自队列研究和临床试验的经验提供了一些见解。根据特定地点的州法规，了解 OIT 团队中每个成员的执业范围非常重要。人员配备和空间可能会决定单个诊所一次可以有多少患者接受 OIT 治疗。必须备有急救药物、用品和方案。本文将介绍筛查、预约、就诊流程、监测、家庭剂量、剂量调整、安全预防措施、不良反应和维持治疗等内容。最后，还将对正在研究中的辅助疗法进行综述。
