Does giving daily small, steadily increasing amounts of egg protein help people with egg allergy?

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Does giving daily small, steadily increasing amounts of egg protein help people with egg allergy?

Updated
Authors: 
Romantsik O, Tosca M, Zappettini S, Calevo M

Background

Until recently, the only practical option for people with food allergies was strict avoidance of foods to which they are allergic. It is difficult to avoid egg because it is found in many foods. Even with avoidance, the fear of accidentally eating foods with egg because of mislabelling or cross-contamination is an ever-present fear for even the most careful of people with food allergy. Accidentally eating egg-containing foods can cause life-threatening events.

Oral immunotherapy is a new type of treatment for egg allergy, which is also known as oral desensitization or vaccination. Treatment involves consuming a small amount of egg protein daily, which is gradually increased over time until a full serving is reached. This method could alter the allergic response to the egg protein by the body’s immune system, increasing the amount of egg that can be eaten without inducing adverse reactions.

Search date

We searched up to March 2017 for this update.

Study characteristics

We included 10 randomized controlled trials (studies that allocate people randomly by chance to receive treatment) that compared oral immunotherapy to placebo (a fake treatment not containing egg) or an egg-avoidance diet for people with egg allergy. The 10 studies included a total of 439 children (249 in the oral immunotherapy group (treatment containing egg) and 190 in the control group (no egg)) who were aged from 1 year to 18 years.

Key results

The evidence showed that treating egg allergy by giving a small, increasing amount of egg may help most children with egg allergy to tolerate a partial serving of egg, so long as they continued to consume a daily amount of egg protein. Side effects were frequent during oral immunotherapy treatment, but were usually mild-to-moderate. Nevertheless, 21 of 249 children treated with oral immunotherapy for egg allergy required medicine because of a serious reaction. The studies did not report information about quality of life of children and their families during oral immunotherapy treatment.

Quality of the evidence

The trials involved small numbers and there were problems with the way they were done, therefore further research is needed.

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