Specific oral immunotherapy in food allergy: Quo vadis?

The current option for food allergic patients remains avoidance of the offending food. However, accidental exposure is common. Accidental reactions can be mild-to-life-threatening. Patients with a higher risk of anaphylactic reactions receive auto-injectable epinephrine for self-medication. Over the last years a lot of research has been conducted on causal treatment options for food allergy, especially on oral immunotherapy. Although efficacy of this treatment has been shown in terms of desensitization, long-term efficacy in regard to tolerance development is not yet proven. More importantly, safety remains a major issue. Even though there are countries performing oral immunotherapy already in routine practice, the majority of experts do not recommend this therapeutic approach outside of clinical trials.