EVALUATION OF ORAL IMMUNOTHERAPY IN HAZELNUT ALLERGY: PEDIATRIC
EXPERIENCE IN TOULOUSE
Abstract
Background: Oral immunotherapy (OIT) seems to be a promising
treatment for hazelnut allergy but the available data is limited. Our
objective was to evaluate the proportion of patients desensitised after
hazelnut OIT, as well as to evaluate the proportion and type of adverse
events (AEs) occurring during OIT and to identify clinical and
biological factors predictive of OIT success. Methods:
Single-center retrospective study, including pediatrics patients. Oral
food challenge (OFC) was performed before and after OIT. For each
patient, we collected clinical data and the level of hazelnut IgEs f17,
nCor a 9, rCor a 14, at the time of the 2 OFCs. Results: After
12 months of OIT, 52.2% of children were desensitized. Those not
desensitized increased their reactogenic dose by 6-fold. One-third
presented an AE, mostly non-serious. They were significantly more likely
to be desensitized if the levels of hazelnut IgE f17, nCor a 9, and rCor
a 14 were initially low. Predictive thresholds of 16.3 kUA/L for
hazelnut IgE f17 (p=0.0066) and 4.13 kUA/L for rCor a 14 (p=0.0447) were
calculated with an NPV of 85%. Conclusion: Hazelnut OIT is
effective in inducing tolerance in 52.2% of children. Children with
lower specific IgEs (hazelnut f17, nCor a 9 and rCor a 14) were
significantly more likely to achieve desensitization after 12 months of
OIT. Predictive thresholds for f17 and rCor a 14 were defined above
which the risks of failure of OIT are high.