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EVALUATION OF ORAL IMMUNOTHERAPY IN HAZELNUT ALLERGY: PEDIATRIC EXPERIENCE IN TOULOUSE
  • +5
  • Natacha Casanovas,
  • V. Gruzelle,
  • Anne Broue-Chabbert,
  • R. Pontcharraud,
  • Jasper Kamphuis,
  • Audrey Martin-Blondel,
  • Laurent Guilleminault,
  • marine michelet
Natacha Casanovas
Hopital des Enfants

Corresponding Author:[email protected]

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V. Gruzelle
Hopital des Enfants
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Anne Broue-Chabbert
Hopital des Enfants
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R. Pontcharraud
Hopital des Enfants
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Jasper Kamphuis
Centre de Physiopathologie de Toulouse-Purpan
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Audrey Martin-Blondel
Hopital des Enfants
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Laurent Guilleminault
Hopital Larrey
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marine michelet
Hopital des Enfants
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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.