Factors associated with home epinephrine-treated reactions during peanut and tree-nut oral immunotherapy

Nachshon, Liat; Schwartz, Naama; Levy, Michael B.; Goldberg, Michael R.; Epstein‐Rigbi, Naama; Katz, Yitzhak; Elizur, Arnon

doi:10.1016/j.anai.2022.12.001

Cited by 3 publications

(3 citation statements)

References 46 publications

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“…Overall, the efficacy of tree nut‐OIT was found to be similar to that demonstrated by peanut‐OIT trials, depending on the protocol 38 . Recent findings suggest that safety may vary depending on the nut 39 . Omalizumab and dupilumab were investigated in RDBPC trials, a case report and two small cohort studies of multi‐food allergic children and adults, with favorable outcomes, leading the FDA to approve omalizumab as a treatment to reduce allergic reactions to multiple foods after accidental exposure 23,30,32,35 …”

Section: Discussionsupporting

confidence: 57%

“…38 Recent findings suggest that safety may vary depending on the nut. 39 Omalizumab and dupilumab were investigated in RDBPC trials, a case report and two small cohort studies of multifood allergic children and adults, with favorable outcomes, leading the FDA to approve omalizumab as a treatment to reduce allergic reactions to multiple foods after accidental exposure. 23,30,32,35 Cross-desensitization between cashew-pistachio and walnutpecan was described, 16,20,21,26,27 attributed to the close phylogenetic affinity of the respective nuts.…”

Section: Main Findingsmentioning

confidence: 99%

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Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Pasioti,

Xepapadaki,

Mathioudakis

et al. 2024

Pediatric Allergy Immunology

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Tree nut allergy is a lifelong and potentially life‐threatening condition. The standard of care is strictly avoiding the culprit nut and treating accidental reactions symptomatically. To evaluate potential therapeutic options for desensitizing patients with IgE‐mediated tree nut allergy, we systematically searched three bibliographic databases for studies published until January 2024. We looked for active treatments of IgE‐mediated allergy to tree nuts (walnut, hazelnut, pistachio, cashew, almond, pecan, macadamia nut, and brazil nut). We focused on allergen‐specific immunotherapy (AIT) using oral (OIT), sublingual (SLIT), epicutaneous (EPIT), or subcutaneous (SCIT) delivery, or other disease‐modifying treatments. We found 19 studies that met our criteria: 3 studies investigated sublingual immunotherapy, 5 studied oral immunotherapy to a single tree nut, and 6 used multi‐food oral immunotherapy with or without omalizumab. The remaining studies investigated the effectiveness of monoclonal antibodies or IgE‐immunoadsorption in multi‐food allergic patients, including patients with tree nut allergy. The heterogeneity of the studies prevented pooling and meta‐analysis. Oral immunotherapy, single or multi‐nut, with or without omalizumab, was the most studied approach and appears effective in conferring protection from accidental exposures. Omalizumab monotherapy is the only approved alternative management for reducing allergic reactions that may occur with accidental exposure.image

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Section: Discussionsupporting

confidence: 57%

Section: Main Findingsmentioning

confidence: 99%

Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Pasioti,

Xepapadaki,

Mathioudakis

et al. 2024

Pediatric Allergy Immunology

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“…However, anaphylactic reactions are possible also during maintenance at home, sometimes requiring epinephrine administration. A recent study [ 89 ] showed that some factors, such as a previous reaction treated in an emergency department or a reaction treated with epinephrine during induction at the hospital can help predict the risk of severe home reactions to OIT. Most patients experiencing these reactions still achieved desensitization with immunotherapy.…”

Section: Prevention and Treatmentmentioning

confidence: 99%

Natural History of Hazelnut Allergy and Current Approach to Its Diagnosis and Treatment

et al. 2023

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Hazelnut allergy is the most prevalent type of nut allergy in Europe, with symptoms that can range from mild, such as hives and itching, to severe, such as anaphylaxis, particularly in patients who are sensitized to highly stable allergens, such as storage proteins. Compared to other types of food allergies, allergies to tree nuts, including hazelnuts, tend to persist throughout life. Although symptoms can appear in early childhood, they often continue into adulthood, with a minority of cases improving during adolescence. Currently, there is no curative treatment available for hazelnut allergy, and patients must adhere to a restrictive diet and carry autoinjective epinephrine. However, oral allergen immunotherapy (AIT) is a promising treatment option. Patients can be categorized based on their risk for severe reactions using various clinical, in vivo, and in vitro tests, including component-resolved diagnosis and oral food challenge. This review aims to provide an overview of the current knowledge of the natural history of hazelnut allergy and new approaches for its diagnosis and management.

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The Future of Food Allergy Management: Advancements in Therapies

Ezhuthachan,

Beaudoin,

Nowak-Wegrzyn

et al. 2024

Curr Allergy Asthma Rep

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Factors associated with home epinephrine-treated reactions during peanut and tree-nut oral immunotherapy

Cited by 3 publications

References 46 publications

Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Natural History of Hazelnut Allergy and Current Approach to Its Diagnosis and Treatment

The Future of Food Allergy Management: Advancements in Therapies

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