Pancake Oral Immunotherapy for Egg Allergy in Inducing Tolerance (POET)

Introduction:

• Egg allergy is the most common food allergy among children in Singapore.
• There is currently no accepted treatment for egg allergy and the management is strict avoidance of egg.
• A person is less likely to outgrow an allergy if it still persists in the later part of childhood.

Purpose of this study:

• Investigate pancake oral immunotherapy (OIT) as a possible new treatment in improving tolerance in egg allergy.

Who we are looking for:

• Children aged 2 to 15 years old who are currently allergic to eggs
• Able to understand and speak English
• Accompanying parent

What the study is about:

Participants will undergo eligibility screening, which may include a baseline screening cooked egg challenge, to confirm current egg allergy. If found to be eligible, participants will be randomly allocated to one of two groups: Active or Control. This means participants will be assigned to one of the two groups below by chance.

1. Active Group
   Participants will undergo a muffin challenge to confirm if they are tolerant of baked-egg products at baseline. Those tolerant of baked egg will commence OIT with pancakes. Those reactive to baked egg will commence OIT with cookies and later continue with pancakes.
   
   Pancakes and/or cookies will be prepared at the participant’s home using standardised recipes. These will be consumed on a daily basis and the quantity will be increased at regular intervals until the top pancake dose is achieved.
   
   A food challenge will be conducted at the end of treatment to assess their tolerance to cooked egg. Participants who do not develop a reaction will then stop OIT for 6 weeks before returning for a repeat cooked egg food challenge.


2. Control Group
   Participants will continue strict avoidance of egg and all foods containing egg. They will undergo a cooked egg food challenge at 12 months to assess for tolerance to cooked egg.

The study will be conducted at KK Women’s and Children’s Hospital (KKH). Total OIT treatment period will last between 12 and 18 months. Apart from hospital visits for all food challenges, participants in the active group will be required to visit the hospital for pancake/cookie dose initiation; and every 4 weeks subsequently for pancake dose increments (a total of about 9 to 11 visits to KKH throughout the study duration). Clinical data will be collected during all hospital visits. Skin prick tests and blood samples will be collected at screening and before the cooked egg challenges at the end of treatment.

Costs of therapy and clinical investigations will be borne by participants, but transport reimbursement will be given on completion of each scheduled visit.

Benefits of participating in the study:

• Oral immunotherapy may protect patients from an unpredictable allergic reaction after treatment has ended.
• You and your child may experience improved quality of life with reduced dietary and social limitations.

To find out more, please contact us at:

• Email Poet.Study@kkh.com.sg

Principal Investigator: Dr Chong Kok Wee