For families with food allergies, micro-managing daily life to avoid accidentally consuming the wrong food can be a huge burden. They scour labels. They avoid restaurants. They ban their kids from birthday parties, or refuse to enter sports stadiums, worrying that peanut shells littering the ground could trigger life-ending anaphylaxis.
Parents want “to do something rather than nothing,” Bales said — even when a treatment carries a risk of unpleasant side effects.
The resulting angst has driven some families and physicians to try a therapy that has done well in early studies but has unclear long-term effects and is not yet approved by the Food and Drug Administration (FDA). The controversial treatment is called oral immunotherapy (OIT). Conceptually, the method works like allergy shots, which for 100 years have reliably treated pollen and other environmental allergies by desensitizing the immune response to these triggers. Instead of injecting allergens through the skin, OIT involves consuming a bit of the forbidden food each day, at gradually increasing doses, so the immune system can learn to put up less of a fight.
Over the past decade, the number of OIT providers has grown from just a handful of doctors nationwide to a small, influential cohort of more than a hundred today. Thousands of food allergy patients who have tried oral immunotherapy in the United States and abroad swear by the treatment, often calling the results life-changing. And with an FDA decision expected by early 2020 for Aimmune Therapeutics’ “peanut capsules,” OIT could soon go mainstream.