Effectiveness and Safety of Home-based Oral Immunotherapy for Wheat Allergy: A Single-Center Analysis

We aimed to investigate the efficacy and safety of the home-based oral immunotherapy (OIT) in children with wheat allergy. Children with wheat allergy aged 3 to 13 increased amount of wheat noodles to the target dose of 120 g (3.6 g of wheat proteins) during the build-up phase. Patients continued 100-200 g of boiled wheat noodles during the maintenance period of 12 months. Historical control group was matched for the age, sex, clinical characteristics, and levels of specific IgE (sIgE) to wheat for comparison with the OIT group. Out of 44 patients, 41 (93.2%) patients in the OIT group achieved desensitization after build-up phase of 3 to 16 months. Two patients failed OFC tests after the build-up phase, while one patients rejected the OFC due to fear of possible allergic reactions. However, only one patient (21/22, 4.5%) in the control group achieved immune tolerance (P <0.001). During OIT, no severe adverse events occurred. In the OIT group, sIgE to wheat and gliadin significantly decreased compared to the control group after build-up periods (all P <0.001). In the OIT group, 4 patients have consumed wheat ad libitum after completion of 12 months of the maintenance period, while 37 subjects have taken 100-200 g of wheat noodles at least 4 times a week for 4-34 months of maintenance period without adverse events. Our results suggest that the home-based OIT using boiled wheat noodles is safe and effective for children with wheat allergy.