Early Introduction of Egg and the Development of Egg Allergy in Children: A Systematic Review and Meta-Analysis

Al‐Saud, Bandar; Sigurdardottir, Sigurveig

doi:10.1159/000492131

Cited by 37 publications

(59 citation statements)

References 24 publications

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“…A number of recent systematic reviews are available and provide useful insights. [11][12][13][14] However, these reviews tend to combine food allergy with other outcomes 15,16 or to focus on one specific intervention, such as infant formula or prebiotics. 17 It is difficult to compare interventions because the inclusion criteria and measurement approaches vary across reviews.…”

Section: Rationalementioning

confidence: 99%

See 1 more Smart Citation

Preventing immediate‐onset food allergy in infants, children and adults: Systematic review protocol

Silva¹,

Halken

Singh³

et al. 2019

Pediatric Allergy Immunology

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Background: More than 17 million people across Europe have allergies to food and the burden of food allergies is increasing. In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published guidelines for preventing food allergy. Important research has been published since then and it is essential to ensure the guidelines reflect the latest evidence. A systematic review will be undertaken to help prepare new guidelines due to be published in 2020. Methods: Eleven bibliographic databases will be searched from inception to 31October 2019 for randomized controlled trials about any intervention designed to prevent the development of new cases of immediate-type/IgE-mediated food allergy in infants, children and adults. There are few randomized controlled trials about the impact of breastfeeding on food allergy so prospective cohort studies about breastfeeding with at least 1000 participants at general risk or 200 at high risk of food allergy will also be eligible. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to assess the certainty of the evidence and tabulate summary data. The risk of bias in individual trials will be assessed using the Cochrane risk of bias tool. All data extraction and quality appraisal will be undertaken independently by two reviewers in partnership with a taskforce of EAACI members. Conclusions:Preventing food allergy has the potential to improve personal well-being and reduce societal healthcare costs. It is important that forthcoming European guidelines take the latest research into account. Past reviews have tended to focus on single interventions or combined food allergy with other outcomes, making it difficult to draw robust conclusions about potential impacts for policy and practice. K E Y W O R D Sadults, children, food allergy, IgE-mediated, infants, prevention This paper sets out the protocol for a systematic review to support updating the EAACI food allergy guidelines, which are due Key MessageFood allergy affects the lives of millions of people throughout Europe and there has been much research published recently about attempts to prevent it. This evidence is of varying quality. Supported by a systematic review and expert insight, the European Academy of Allergy and Clinical Immunology's (EAACI) forthcoming guidelines will help countries, regions and individual clinicians make appropriate recommendations about the most effective and safe strategies to help prevent the individual and societal issues associated with food allergy. This article describes the methodology of a systematic review to support updating guidelines that were published in 2014.

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Section: Rationalementioning

confidence: 99%

“…28 For some topics, such as hydrolysed infant formula or the early introduction of egg or peanut into infant diets, meta-analyses have already been conducted. 11,13,15 The reviewers will draw on these in the review narrative rather than replicating existing work.…”

Section: Grading Of Recommendations Assessment Development Andmentioning

confidence: 99%

Preventing immediate‐onset food allergy in infants, children and adults: Systematic review protocol

Silva¹,

Halken

Singh³

et al. 2019

Pediatric Allergy Immunology

View full text Add to dashboard Cite

show abstract

“…Di Mario and Cattaneo [1] wrote a letter with several critiques on our recent published systematic review and meta-analysis on early introduction of egg and the development of egg allergy in children [2]. The points addressed are extremely important.…”

mentioning

confidence: 99%

“…The primary outcome in the study by Tan et al [4] was egg sensitization by allergy skin tests; however, they also had oral food challenge at 12 months, which was reported as a secondary outcome data that we and others [5] extracted for the meta-analysis. The first trial by Palmer et al [6] included only patients with eczema; however, all the other trials had patients with eczema as well (range 9–100%) [2]. Di Mario and Cattaneo suggested to exclude these three trials [3, 4, 6] from the analysis because of clinical heterogeneity.…”

mentioning

confidence: 99%

Early Introduction of Egg and Development of Egg Allergy

Al‐Saud

Sigurdardottir

2019

Int Arch Allergy Immunol

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“…The meta-analysis by Al-Saud and Sigurdardóttir [1] on egg introduction in infants and the risk of egg allergy, including 6 randomized controlled trials, concludes that early (between 3 and 6 months of age) egg introduction is associated with a lower risk of egg allergy. The authors are cautious and stress that evidence is only of moderate quality and that there is considerable clinical heterogeneity but fail to acknowledge a couple of critical problems within their meta-analysis that challenge their conclusions.…”

mentioning

confidence: 99%