Efficacy and Safety of Low-dose Sesame Oral Immunotherapy in Pediatric Patients

Allergic reactions to sesame can be severe and life‐threatening, making it challenging to avoid hidden sources of the allergen. This pilot study is a randomized controlled trial evaluating the efficacy and safety of oral immunotherapy (OIT) with a low‐dose sesame protein in pediatric patients with sesame allergy. The study aims to compare participants undergoing OIT with a maintenance dose of 300mg sesame protein against a control group in a 2:1 randomized allocation. The control group will be recommended a standard treatment, which is a restrictive elimination diet and the use of emergency treatment, including adrenaline, in case of accidental exposure to sesame. 39 participants aged 3‐17 with confirmed IgE‐mediated sesame allergy will be enrolled into the study. Interventions will be administered once daily for up to 18 months, and the control group will stay under observation for one year. Primary outcomes include the proportion of participants tolerating a single dose of 4000mg sesame protein during the final oral food challenge. Secondary outcomes assess adverse events, changes in immunological parameters, and the maximum tolerated doses of sesame protein in each group.