Hi, I’m looking for codes of Oral Immunotherapy.
You want concepts for oral immune suppressing drugs? Which ones?
Hello, I am looking for codes for oral immunotherapy. It’s not medicine, it’s treatment, usually in a hospital or clinic for life-threatening food allergies (nuts, milk, eggs, etc.).
All drug substances in OMOP CDM are meant to go into DRUG_EXPOSURE table, whether if administered during a procedure in a hospital or bought OTC.
In OMOP CDM, the most generic way to describe a drug is a specific Ingredient. If you need a more general drug group, like an ATC code, you would need to build a concept set in ATLAS. There is hierarchy in place between ATC and standard drug Ingredients (example – immunosupresants), so you can try to leverage it.
Thank you for your answer. The OIT is not a drug, it’s a food desensitization therapy which helps desensitize patients to the very foods they are allergic to by giving them small quantities of the food allergen to ingest every day and gradually building their body’s resistance to the food. There is a new drug PALFORZIA available since 2020 on the NHS as a possible treatment for only peanut allergy in children aged 4 to 17.
I’m trying to define data of children with food allergy getting the OIT (small quantities of the food allergen) not the drug.
@Natafl You should check Athena for these treatments/drugs. Regulated drug products are used for food desensitization. The one I linked is based on Arachis hypogaea, the latin name for peanut. There are other drug products in RxNorm for other common allergens.
This query returns 9729 Standard, Valid, Drug concepts containing “allergen”.
You are correct that besides the sole approved peanut OIT (at least in the US), this is a PROCEDURE. Procedures are - honestly - sometimes hard. In the US, these have been slower to get into proper standardized vocabularies as they are tied to a proprietary coding system (CPT4). However, looking at the CPT4 for desensitization therapy, we end up at the UMLS UMLS Metathesaurus Browser … there are many SNOMED procedure codes under these (top level maybe
SNOMED 182678001). Successfully finding these will likely be a little bit of a challenge.
I’m trying to define a cohort of children with food allergy getting the OIT treatment (small quantities of the food allergen) not the drug. All types of food: nuts, peanuts, eggs, milk etc.
Yeah, won’t be easy. The procedure should be Desensitization therapy, but if the allergen is food you are out of luck finding concepts for that. Food is just not a clearly defined concept. A pizza in New York is not the same thing as a pizza in Chicago, and neither have much to do with the food of the same name in Napoli. You will have to extend your model with string fields for the food, and then do your own ad-hoc standardization or harmonization.
Let us know.
I assume the OIT doesn’t consist of giving patients actual “food”, right? I assume the allergen is given in controlled doses of a known agent (i.e. a “drug”) containing an ingredient such as peanut allergen extract.
Actualy the OIT treatment is giving patients actual small controlled dozes of food (not a drug) ןn a hospital or clinic under the supervision of medical staff
There is actually a procedure “food desensitization therapy” but nobody uses it, so I don’t see any cases there. I also combined patients with a “food allergy” observetion and desensitization therapy procedure, and no cases were found either.
I looked into a typical US claims database, and desensitization procedures claimed are:
- “Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract” - with various number of “stinging insect venoms” extracts as allergen
- “Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy”, again with the “stinging insect venoms”
- “Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)”
Which means these are desensitizations against insect venoms and drugs or substances. Not sure how food sensitization is claimed.
Per a single private practice allergist in the US. OIT is a series of visits (initial and step up). All visits are coded by CPT as oral food challenge. Palforzia OIT is sometimes covered as a prescription and typically associated with a ICD 10 dx code for peanut allergy. Palforzia itself is not considered a procedure.