Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Division of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Manitoba, Canada.
Curr Allergy Asthma Rep. 2021 Apr 30;21(4):30. doi: 10.1007/s11882-021-01009-8.
The purpose of this review is to discuss how to best incorporate oral immunotherapy into your clinical practice based on recent evidence and guidelines, and address controversies.
Oral immunotherapy is the food immunotherapy treatment with the most literature supporting its use. Recent data from both randomized clinical trials and real-world studies show OIT is especially safe and effective in preschoolers, while avoidance may be less safe than previously thought. OIT guidelines support its use outside of research. Oral immunotherapy can be safely and effectively incorporated into your clinical practice, with careful planning and consideration of scenarios where benefits outweigh risks. Baseline oral food challenges are necessary in clinical trials, but in clinical practice, these are best done when the history is unclear due to resource limitations. There is a role for both regular food and FDA-approved products. Future research should focus on optimizing safety and adherence in the real-world setting.
本文旨在根据最新证据和指南，讨论如何将口服免疫疗法最佳纳入临床实践，并解决相关争议。
口服免疫疗法是文献支持其应用最多的食物免疫疗法。来自随机临床试验和真实世界研究的最新数据表明，OIT 尤其在学龄前儿童中安全且有效，而避免接触过敏原可能不像以前认为的那样安全。OIT 指南支持在研究之外使用。口服免疫疗法可以安全有效地纳入临床实践，但需要仔细规划，并考虑获益大于风险的情况。在临床试验中需要进行口服食物激发试验作为基线检查，但在临床实践中，由于资源限制，当病史不明确时，最好进行该检查。常规食物和 FDA 批准的产品都有一定作用。未来的研究应侧重于优化真实环境下的安全性和依从性。
