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Allergy, Asthma & Clinical Immunology

Open Access

Oral immunotherapy for milk allergy: a systematic review

  • Joanne P Yeung1Email author,
  • Lorie A Kloda2,
  • Jason R McDevitt3,
  • Moshe Ben-Shoshan1 and
  • Reza Alizadehfar1
Allergy, Asthma & Clinical Immunology20128(Suppl 1):A14

Published: 2 November 2012


Public HealthSystematic ReviewEpinephrineAdverse ReactionMethodological Quality


Milk oral immunotherapy (MOIT) may be an alternative to avoidance in treatment of patients with IgE-mediated cow milk allergy (IMCMA). We aim to determine the effect of MIOT through a systematic review.


Randomized controlled trials on MOIT were identified from 13 databases, conference proceedings, theses and unpublished trials, as part of a review with the Cochrane Collaboration. A total 1945 records were identified and screened. Children and adults with IMCMA were included. Studies were selected and methodological quality assessed independently by two reviewers.


138 records were reviewed and 13 were included, representing 4 trials. A total of 170 patients were studied (88 MOIT, 82 control). Two studies used blinding and 2 used an avoidance diet control. Fifty-two (59%) patients of the MOIT group were able to tolerate a full serving of milk (about 200 mL) compared to 7 (9%) of the control group (RR 6.05, 95% CI 3.2, 11.44). In addition, 26 (30%) in the MOIT group could ingest a partial serving of milk (10-184 mL) while none could in the control group (RR 11.55, 95% CI 2.85, 46.87). None of the studies assessed the patients following a period off immunotherapy. Adverse reactions were common (79 of 88 had at least one symptom), although most were local and mild. For every 7 patients receiving MOIT, 1 required intramuscular epinephrine. One patient required it on 2 occasions.


MOIT can lead to desensitization in the majority of individuals with IMCMA although the development of long-term tolerance has not been established.

Authors’ Affiliations

Pediatric Allergy and Immunology, McGill University, Montreal, Canada
Libraries, McGill University, Montreal, Canada
Faculty of Medicine, McGill University, Montreal, CanadaH3A 1W9


© Yeung et al; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.