Advancements in Pediatric Oral Immunotherapy: Insights from ACAAI 2025

The SoRT trial, which was presented at the 2025 American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting, showed improved safety when pediatric oral immunotherapy (OIT) began with baked allergen forms, reporting fewer systemic reactions and better tolerability among children.

The SoRT protocol compared high-dose, low-dose, and baked/processed forms for milk and peanut OIT, using systemic allergic reactions as the primary safety endpoint. There was an approximately 35% reduction in systemic reactions with baked milk and peanut OIT versus nonbaked protocols in the pediatric cohort.

Baked formulations and lower-dose initiation produced measurable safety gains compared with earlier high-dose approaches, shifting the safety profile and reducing the frequency of acute systemic events for milk and peanut OIT in children. These findings suggest that personalized