About the OIT Program

When children have severe allergies to common foods like milk, eggs and nuts, families must remain hypervigilant to keep their children safe. Even the smallest exposure to the allergen can cause an extreme reaction called anaphylaxis, in which the immune system begins to attack itself, causing tissues in the body to swell, the airways to close and the heart and lungs to fail. Today, patients treated at Children's Hospital of Philadelphia (CHOP) have a new treatment option: oral immunotherapy.

What is oral immunotherapy?

Oral immunotherapy, or OIT, helps desensitize children to the foods they are allergic to by giving them small quantities of the allergen every day at home, and then gradually increasing the amount under medical supervision at the hospital. OIT has been shown to be effective in 60-80% of research trials.

Currently, CHOP’s Food Allergy Center offers oral immunotherapy for up to five foods at a time. For certain allergens, we will offer an FDA-approved product, such as Palforzia™.

Once your child has reached a “maintenance dose” — a low dose of the allergen that has proven to protect individuals against exposure to larger quantities of the same food — your child will remain at this dose for a period of time. This extended “maintenance” dosing has been proven effective against many food allergens.

OIT safety

Because patients participating in oral immunotherapy will ingest a food they are allergic to, all dose increases must occur under medical supervision at CHOP’s Oral Immunotherapy Program, overseen by Medical Director Antonella Cianferoni, MD. Before OIT begins, your child will complete oral food challenges to determine their level of sensitivity to each food. This process will be individualized based on your child’s medical history.

Healthcare providers and medical staff are assigned to monitor patients during and after increased dosing because allergic reactions and anaphylaxis are a risk when patients are exposed to a food allergen — even a controlled amount.

Eligibility requirements

To be eligible to participate in OIT at CHOP, children must:

• Be a current patient of CHOP’s Food Allergy Center in the Division of Allergy
• Demonstrate allergy to at least one allergen through a positive skin test, blood test and/or food challenge
• Be in good health

- Patients with other chronic illnesses, like asthma or allergic rhinitis, can participate in oral immunotherapy if their symptoms are under good control.

In addition, families must agree to always carry emergency medications with them.

Maintenance dosing and exiting food challenge

After your child performs food challenges, the clinical team will be able to determine when to start OIT dosing. Some children can increase the dosage of their allergen every two weeks, commonly called “up-dosing.” Others may need more time to build up their body’s resistance to the allergen.

Initial up-dosing visits will occur at CHOP’s Philadelphia or King of Prussia campuses; while subsequent visits can take place at any of our other CHOP Allergy satellite offices in Brandywine Valley, Exton, Princeton or Voorhees.

Once your child has reached maintenance dosing, they will return for an OIT Program visit every three months for one to three years (depending on the allergen). After a year of maintenance dosing, your child will be offered a milestone challenge to determine how much of the allergen your child can safely consume without adverse reactions.

Getting started with OIT & Numbers

If you believe your child may benefit from oral immunotherapy, talk to your child’s allergy provider. The provider can refer your family to the OIT Clinic at CHOP. To participate in OIT, your family must agree to participate in the following:

1. An intake visit to evaluate your child’s food allergy history and care plan.

2. Food challenges based on your child’s history if not completed during the past year. This may include repeating skin testing and blood work.

3. Up-dosing visits every two to four weeks at the hospital or one of our satellite offices so clinicians can monitor your child’s reaction.

4. Maintenance dose visits to the oral immunotherapy program at least every three months.

To learn if OIT is appropriate for your child, visit chop.edu/OIT or email OIT@chop.edu.