Comment: The quality of evidence is downgraded by study limitations (lack of blinding) and by imprecise results (small trials and few patients).
A Cochrane review included 4 studies with a total of 167 subjects, all of whom were children (aged 4 to 15 years). One study used a placebo and 3 studies used an avoidance diet as the control. Each study used a different oral immunotherapy (OIT) protocol. 39 per cent of OIT participants were able to tolerate a full serving of egg compared to 11.9% of the controls (RR 3.39, 95% CI 1.74 to 6.62). 40 per cent of OIT participants could ingest a partial serving of egg (1 g to 7.5 g; RR 5.73, 95% CI 3.13 to 10.50). 69 per cent of the participants presented with mild-to-severe adverse effects during OIT (RR 6.06, 95% CI 3.11 to 11.83). Five of the 100 participants receiving OIT required epinephrine. The studies were small and the quality of evidence was low. Current evidence suggests that OIT can desensitize a large number of egg-allergic patients, although it remains unknown whether long-term tolerance develops.
Date of latest search: 5 December 2013