Rationale: Egg OIT results in sustained unresponsiveness (SU) in a subset of egg-allergic children; however, long-term treatment effects off-therapy are not established.
Methods: Egg-allergic children (5-18 y/o) received egg OIT (n=40), maximum 4 years, or placebo (n=15), maximum 1 year. Through year 4, subjects were assessed as SU (passed OFC after 4-6 weeks off OIT) or desensitized (D) (passed OFC on therapy only). SU subjects were instructed to add unbaked egg ad libitum; other subjects added egg independent of physician instruction. Long-term, follow-up questionnaires (LFQ) were administered at a median of 61.6 months from enrollment to assess unbaked (lightly cooked) vs. baked (heat-denatured) egg consumption in current diet and symptoms.
Results: Of 40 egg OIT-treated subjects, 22/40(55%) were SU by year 4 (versus 27.5% at year 2). Of 8,925 egg OIT doses in years 2-4, 95% were symptom-free. 45/55 (81.8%) subjects completed the LFQ. More egg OIT subjects [23/34(67.6%)] consumed unbaked and baked egg vs. placebo subjects [2/11(18.2%)] (p=0.006). 20/20 (100%) OIT-SU subjects were consuming all forms of egg in their diet. 7/8 (87.5%) OIT-D subjects were consuming some egg; 3 unbaked and 4 only baked egg. 1/6 (16.7%) OIT-not-desensitized subjects were consuming only baked egg. 4/11 (36.4%) placebos were consuming some egg; 2 unbaked and 2 only baked egg.
Conclusions: Findings suggest sustainability of long-term egg consumption among subjects demonstrating SU after completion of egg OIT. Future work is needed to identify individuals who will benefit from egg OIT.