Low-Dose Liquid Egg Oral Immunotherapy Shows Promise for Egg-Allergic Children: Study

A new study published in the Annals of Allergy, Asthma & Immunology journal showed that in an outpatient context, the most effective way to induce tolerance in children with egg allergies was to begin oral immunotherapy (OIT) with low-dose pasteurized liquid egg.

One of the most prevalent IgE-mediated food allergies is egg allergy. The inclusion of eggs into the diet is not supported by any FDA-approved therapy. Studies have demonstrated that oral immunotherapy protects against accidental ingestion and may permit patients to freely consume eggs; however, methods, effectiveness, and side effects differ. Thus, this study was set to evaluate the effectiveness and safety of three distinct office-based egg OIT methods.

This retrospective analysis of children who had egg OIT at the Children's Hospital of Philadelphia (CHOP) happened between 2018 and 2023. Nguyen et al. previously documented OIT safety and feasibility at CHOP. Over ten clinicians, including board-certified allergists and allergy advanced nurse practitioners, screened patients for potential OIT candidates for this study. Those who were judged suitable candidates were started on OIT protocols, which included baked egg, high-dose native egg, and low-dose native egg. Examine the three procedures' safety profiles and results.

96 people in all had egg OIT. 43% of them were female, and the average age was 8.4 years. When compared to the other two OIT protocols, premedication and epinephrine usage were less common among those receiving low-dose egg OIT.

Of the 96 patients, 57 (58%) passed a complete oral food challenge to 12g of native egg protein and liberalized their diet to include eggs, 25 (26%) stopped or were lost to follow-up, and 71 (74%) could freely eat baked egg with at least 3g of native egg.

Low-dose egg OIT was shown to be well tolerated and allowed the greatest percentage of patients to reintroduce eggs into their diets when the three OIT protocols were compared. For the treatment of egg allergy in an outpatient context, egg OIT is a workable, secure, and successful treatment.

During the initial dosage increase, this strategy maintained a low risk of adverse effects while achieving the greatest success rates. Overall, these findings may aid in increasing the use of egg oral immunotherapy and improving treatment availability for kids with egg allergies.

Source:

Buckey, T. M., Giannì, G., Hanna, E., Lewis, M. O., Nguyen, K., Calafatti, M., Sweeney, K., Ram, G., Datta, R., Spergel, J. M., & Cianferoni, A. (2026). Safety and efficacy of three office-based egg oral immunotherapy protocols. Annals of Allergy, Asthma & Immunology: Official Publication of the American College of Allergy, Asthma, & Immunology. https://doi.org/10.1016/j.anai.2026.05.035