An Approach to the Office-Based Practice of Food Oral Immunotherapy.

Abstract Oral immunotherapy (OIT) provides an active treatment option for patients with food allergies. OIT may improve quality of life and raise the threshold at which a patient with food allergy may react to an allergen, but it is a rigorous therapy that requires a high degree of commitment by the clinician, patients, and families. Recent guidelines from the Canadian Society for Allergy and Clinical Immunology (CSACI) have provided a framework for the ethical, evidence-based and patient-oriented clinical practice of OIT, and the European Academy of Allergy Asthma and Immunology (EAACI) guidelines have also recommended that OIT can be used as a potential treatment. The recent FDA approval of an OIT pharmaceutical has accelerated the adoption of OIT. This review provides a summary of the recent CSACI guidelines and a consensus of practical experience of clinicians across the US and Canada related to patient selection, office and staff preparation, the general OIT process, OIT-related reaction management, and treatment outcomes.