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This space is non\u2010vascularized and impermeable, which limits allergen exposure into the bloodstream but preserves antigen presentation to regional lymph nodes to generate gut\u2010homing regulatory T cells. The EPIT patch utilizes natural water loss from the skin to absorb electrosprayed allergen through condensation. EPIT represents an alternative, non\u2010oral route of immunotherapy for food allergy, with good efficacy and strong safety profiles across multiple phase 2 and 3 studies for milk and peanut. Efficacy appears the best in very young children (1\u20133\u2009years old), which has been shown to continue to enhance with extended treatment duration up to 36\u2009months. Efficacy in slightly older children ages 4\u201311\u2009years of age is less clear, but appears to be better in children ages 4\u20137\u2009years of age. In clinical trials of milk and peanut EPIT, most subjects experienced adverse effects, mainly mild\u2010to\u2010moderate skin reactions localized around the patch placement site, which improve with continued duration of wear. Rates of treatment\u2010related anaphylaxis have been very low across all studies and ages, ranging from 1.6% to 4%, and were lowest in the infant and toddler population. While further studies of safety (1\u2010 to 3\u2010year\u2010olds) and efficacy (4\u2010 to 7\u2010year\u2010olds) are ongoing, EPIT is a potentially valuable addition to the current landscape of food allergy therapies, in particular for infants and toddlers where families may be seeking a non\u2010oral route of treatment.\n                    <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                      <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/pai70096-fig-0003-m.png\">\n                        <jats:alt-text>image<\/jats:alt-text>\n                      <\/jats:graphic>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1111\/pai.70096","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T01:09:02Z","timestamp":1745629742000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Epicutaneous immunotherapy: A review of safety and efficacy"],"prefix":"10.1111","volume":"36","author":[{"given":"Aikaterini","family":"Anagnostou","sequence":"first","affiliation":[{"name":"Department of Allergy and Immunology Texas Children's Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2365-9372","authenticated-orcid":false,"given":"Matthew","family":"Greenhawt","sequence":"additional","affiliation":[{"name":"Section of Allergy and Clinical Immunology, Children's Hospital Colorado University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.14666"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2021.10.018"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1373110"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.26857"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2022.100687"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2022.04.008"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-023-01121-x"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2014.06.027"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2022.08.011"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.5630"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-1235"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2020.01.008"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/clt2.12064"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2023.2201438"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2023-326225"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2024.02.019"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2024.02.039"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2024.07.034"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2024.05.051"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2024.10.008"},{"key":"e_1_2_12_22_1","volume-title":"Package Insert. 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