Oral Immunotherapy, Sublingual Immunotherapy, or Epicutaneous Immunotherapy: Which Is the Right Solution?

The current standard of care treatment for food allergy relies on avoidance. However, as outlined in this review, over the past decade, the literature has grown significantly showing promising results for interventional therapies for IgE-mediated food allergies utilizing oral immunotherapy (OIT), sublingual immunotherapy (SLIT), and epicutaneous immunotherapy (EPIT). Within the near future, we expect to have multiple FDA-approved products on the market for treatment of life-threatening food allergies and will have options to present to our patients. As we move into this next phase of our practice, we will need to consider meaningful endpoints for our patients (e.g., likelihood of inducing desensitization versus sustained unresponsiveness, the relevance of various threshold changes induced by therapy, effects on quality of life, etc.). This review provides a comprehensive overview of the currently published literature and will prepare the practicing allergist for a thoughtful discussion with their patients and colleagues on the most recent developments in the field.