Food oral immunotherapy: Lessons learned

Background: Immunoglobulin E‐mediated food allergy affects up to 10% of the U.S. population and greatly impacts an individual’s quality of life, posing significant health risks as well as emotional and social burdens on patients and families. Oral immunotherapy (OIT) has emerged as a promising treatment aimed at desensitization and increasing tolerance to food allergens. Methods: This review summarizes current evidence on the safety, efficacy, and challenges associated with OIT. Results: Clinical trials have demonstrated that OIT can desensitize 60‐80% of patients, especially when initiated at a younger age, although the ability to maintain unresponsiveness after discontinuation varies. Despite its benefits, OIT carries risks that contribute to discontinuation in a subset of patients. Conclusion: Shared decision-making is critical in guiding families through OIT, helping them weigh the risks and benefits, while aligning treatment with personal goals. Real-world data, clinical trials, and emerging therapies continue to refine OIT practice and offer hope for broader adoption in the management of food allergies.