EAACI Guidelines on allergen immunotherapy: IgE‐mediated food allergy

Food allergy can result in considerable morbidity, impairment of quality of life, and healthcare expenditure. There is therefore interest in novel strategies for its treatment, particularly food allergen immunotherapy (FA‐AIT) through the oral (OIT), sublingual (SLIT), or epicutaneous (EPIT) routes....

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Published in:Allergy (Copenhagen) Vol. 73; no. 4; pp. 799 - 815
Main Authors: Pajno, G. B., Fernandez‐Rivas, M., Arasi, S., Roberts, G., Akdis, C. A., Alvaro‐Lozano, M., Beyer, K., Bindslev‐Jensen, C., Burks, W., Ebisawa, M., Eigenmann, P., Knol, E., Nadeau, K. C., Poulsen, L. K., van Ree, R., Santos, A. F., du Toit, G., Dhami, S., Nurmatov, U., Boloh, Y., Makela, M., O'Mahony, L., Papadopoulos, N., Sackesen, C., Agache, I., Angier, E., Halken, S., Jutel, M., Lau, S., Pfaar, O., Ryan, D., Sturm, G., Varga, E.‐M., van Wijk, R. G., Sheikh, A., Muraro, A.
Format: Journal Article
Language:English
Published: Denmark Blackwell Publishing Ltd 01.04.2018
Subjects:
adolescent
adult
allergen immunotherapy
Allergens
allergy
Animals
Clinical trials
Cow's milk
Decision making
Desensitization, Immunologic - methods
Desensitization, Immunologic - standards
food
Food allergies
Food Hypersensitivity - prevention & control
Humans
Immunoglobulin E
Immunoglobulin E - immunology
Immunological tolerance
Immunotherapy
Morbidity
Patients
pediatric
Pediatrics
Quality of life
Teenagers
Tongue
adolescent
allergy
allergen immunotherapy
adult
food
pediatric
ISSN:0105-4538, 1398-9995, 1398-9995
Online Access:Get full text
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Summary:Food allergy can result in considerable morbidity, impairment of quality of life, and healthcare expenditure. There is therefore interest in novel strategies for its treatment, particularly food allergen immunotherapy (FA‐AIT) through the oral (OIT), sublingual (SLIT), or epicutaneous (EPIT) routes. This Guideline, prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Task Force on Allergen Immunotherapy for IgE‐mediated Food Allergy, aims to provide evidence‐based recommendations for active treatment of IgE‐mediated food allergy with FA‐AIT. Immunotherapy relies on the delivery of gradually increasing doses of specific allergen to increase the threshold of reaction while on therapy (also known as desensitization) and ultimately to achieve post‐discontinuation effectiveness (also known as tolerance or sustained unresponsiveness). Oral FA‐AIT has most frequently been assessed: here, the allergen is either immediately swallowed (OIT) or held under the tongue for a period of time (SLIT). Overall, trials have found substantial benefit for patients undergoing either OIT or SLIT with respect to efficacy during treatment, particularly for cow's milk, hen's egg, and peanut allergies. A benefit post‐discontinuation is also suggested, but not confirmed. Adverse events during FA‐AIT have been frequently reported, but few subjects discontinue FA‐AIT as a result of these. Taking into account the current evidence, FA‐AIT should only be performed in research centers or in clinical centers with an extensive experience in FA‐AIT. Patients and their families should be provided with information about the use of FA‐AIT for IgE‐mediated food allergy to allow them to make an informed decision about the therapy.
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ISSN:0105-4538
1398-9995
1398-9995
DOI:10.1111/all.13319