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\begin{document}

\title{Efficacy and safety of food allergy oral immunotherapy in adults}



\author[1]{Na'ama  Epstein Rigbi }%
\author[1]{Michael Levy}%
\author[1]{Liat Nachshon}%
\author[1]{Yael Koren}%
\author[1]{Yitzhak Katz}%
\author[1]{Michael Goldberg}%
\author[1]{Arnon Elizur}%
\affil[1]{Shamir Medical Center Assaf Harofeh}%


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  \date{May 24, 2024}


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\begin{abstract}
\textbf{Background}. Oral immunotherapy (OIT) is an emerging method for
treating food allergy in children. However, data regarding adults
undergoing this process is lacking. \textbf{Methods.} We retrospectively
analyzed the medical records of patients with food allergy aged [?]17
years who completed OIT treatment between April 2010 to December 2020 at
Shamir medical Center. Data was compared to that of children aged 4 to
\textless{}11 years and adolescents aged [?]11 to 17 treated during the
same time period. \textbf{Results.} A total of 96 adults at a median age
of 22.3 years who underwent OIT for milk (n=53), peanut (n=18), sesame
(n=7), egg (n=5) and tree nuts (n=13) were analyzed and compared to 1299
children and 309 adolescents. Adults experienced more adverse reactions
requiring injectable epinephrine, both during in-clinic up-dosing (49\%
vs. 15.9\% and 26.5\% for children and adolescents respectively,
p\textless{}0.0001) and during home treatment (22.9\% vs. 10.5\%,
p=0.001 for children, and 14.2\%, p=0.06 for adolescents). Most adults
(61.5\%) were fully desensitized, but rates of full desensitization were
significantly lower compared to children (73.4\%, p=0.013).
Significantly more adults (28.3\%) undergoing milk OIT failed treatment
compared to children (14.3\%, p=0.015) and adolescents (14.1\%,
p=0.022), while failure rates in adults undergoing OIT for other foods
were low (9.3\%) and comparable to children and adolescents.
\textbf{Conclusions.} OIT is successful in desensitizing most adults
with IgE-mediated food allergy. Adults undergoing milk OIT are at
increased risk for severe reactions and for OIT failure while failure
rates in adults undergoing OIT for other foods are low.%
\end{abstract}%



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