title: Allergist-reported trends in the practice of food allergen oral immunotherapy.
abstract: Food allergen oral immunotherapy (OIT) is an experimental, immune-modifying therapy that may induce clinical desensitization in some patients. OIT is still in early phase clinical research, but some providers may offer OIT as a clinical service. To understand the current practices of allergists who perform OIT, an online survey was sent by e-mail to members of the American Academy of Allergy Asthma & Immunology. Among 442 respondents, 61 reported participating in using OIT (13.8%), including 28 in nonacademic settings. Informed consent for OIT was obtained by 91.3%, institutional review board approval by 47.7% and Investigational New Drug approval by 38.1%. Compared with nonacademic participants, more academic participants used peanut OIT, obtained institutional review board and Investigational New Drug (P < .0001 respectively), and challenged patients before entry (P = .008). More nonacademic providers billed the patient or insurance for reimbursement (P < .0001). Low reported regard for the importance for US Food and Drug Administration approval or a standardized product (increased odds), and a high regard for better safety data (decreased odds) were associated with considering offering OIT as a service. Significant differences exist with OITs that occur in academic versus nonacademic settings. Further assessment is needed regarding the different motivations and practice styles among providers who offer OIT and those who are considering doing so.
authors.affiliation: Division of Allergy and Clinical Immunology, Department of Internal Medicine, The University of Michigan Medical School, University of Michigan Health System; The University of Michigan Food Allergy Center; The Child Health Evaluation and Research Unit, Department of Pediatrics, The University of Michigan Medical School, Ann Arbor, Mich.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Greenhawt
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, The University of North Carolina-Chapel Hill, Chapel Hill, NC. Electronic address: bvickery@email.unc.edu.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Vickery
mesh_terms: D000486:Allergy and Immunology / Q000706:statistics & numerical data*; D002170:Canada; D003888:Desensitization, Immunologic / Q000379:methods* / Q000706:statistics & numerical data*; D005512:Food Hypersensitivity / Q000628:therapy*; D006801:Humans; D014481:United States
keywords: Clinical trial; Food allergy; Food oral immunotherapy; Oral food challenge; Provider attitudes; Sublingual immunotherapy