Oral food challenge with raw egg: Sixty‐minute‐ compared with 30‐minute dosing interval

Gradman, Josefine; Petersen, Birgitte Tusgaard; Halken, Susanne

doi:10.1111/cea.14187

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…The Japanese guidelines recommend intervals of at least 20 min, and the Japanese manual on OFC recommends intervals of at least 30 and 60 min if the number of doses is three and two, respectively, or if the challenge food is an egg. Recent studies support the importance of sufficient intervals [37–42] (Table 4); these findings may also suggest that determining the threshold using OFCs with short intervals may be inappropriate. In daily practice, we typically divide the total dose into two or three doses and administer them at an interval of 60 min.…”

Section: Protocols Of Oral Food Challengementioning

confidence: 90%

Management of food allergy based on oral food challenge

Ishibashi,

Yanagida,

Sato

et al. 2024

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review Food allergy is a growing health problem that affects both patients and society in multiple ways. Despite the emergence of novel diagnostic tools, such as component-resolved diagnostics (CRD) and basophil activation tests (BAT), oral food challenge (OFC) still plays an indispensable role in the management of food allergies. This review aimed to highlight the indications and safety concerns of conducting an OFC and to provide insights into post-OFC management based on recent findings. Recent findings Standardized OFC protocols have regional diversification, especially in Japan and Western countries. Recent studies suggested that the interval between doses should be at least more than an hour. Furthermore, applying a stepwise method tailored to the patient's specific immunoglobulin E level and history of anaphylaxis seems to mitigate these risks. Recent surveys have shown that, following a positive OFC, options other than strict avoidance are also selected. Summary OFC serves diverse purposes, yet the risks it carries warrant caution. The stepwise protocol appears promising for its safety. Subthreshold consumption following OFC shows potential; however, further research on its efficacy and safety is required. Management following OFC should be tailored and well discussed between clinicians and patients.

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Section: Protocols Of Oral Food Challengementioning

confidence: 90%

Management of food allergy based on oral food challenge

Ishibashi,

Yanagida,

Sato

et al. 2024

Current Opinion in Allergy &Amp; Clinical Immunology

View full text Add to dashboard Cite

show abstract

“…Physicians should carefully observe children undergoing wheat OFCs, similar to those undergoing egg OFCs, especially for 60 min after the initial wheat dose and for at least 2 h after the last wheat dose. 12 Symptoms during milk OFCs may appear earlier than those during wheat OFCs, and the observation period may vary depending on the antigen. Further studies are needed to elucidate the mechanisms underlying the different timings of symptoms between milk and wheat.…”

Section: Discussionmentioning

confidence: 99%

“…Our study suggests that protocols for milk OFC should have a dosing interval of more than 30 min to improve the overall safety of the OFC. Physicians should carefully observe children undergoing wheat OFCs, similar to those undergoing egg OFCs, especially for 60 min after the initial wheat dose and for at least 2 h after the last wheat dose 12 . Symptoms during milk OFCs may appear earlier than those during wheat OFCs, and the observation period may vary depending on the antigen.…”

Section: Discussionmentioning

confidence: 99%

Timing of initial symptom onset during milk and wheat challenges: A retrospective study

Yanagida,

Minoura,

Sato

et al. 2024

Immunity Inflam & Disease

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BackgroundAllergic reactions to milk appear sooner than those to hen's eggs, irrespective of the total dose of the oral food challenges (OFCs) and type of matrices. The reported median times for the first symptom occurrence are 20–30 min with milk and 50–60 min with eggs. However, allergic reactions due to wheat have not yet been fully investigated.MethodsThis study retrospectively collected data from OFC for milk and wheat conducted at Sagamihara National Hospital and Sendai Medical Center from 2009 to 2023. The time from the start of the OFC to the onset of symptoms was compared between children with cow's milk and wheat allergy.ResultsTwenty‐five and 13 children reacted to single‐dose OFCs with milk products equivalent to 25 mL of raw cow's milk or 15 g of udon noodles, respectively. The median ages of patients with positive challenges were 1.4 and 2.8 years for milk and wheat, respectively, and the median times for the first symptom occurrence were 20 min and 53 min, respectively (p = .006).ConclusionThis multicenter study was the first to examine the time of symptom appearance during single‐medium‐dose milk and wheat challenges. Allergic reactions to wheat appear later than those for milk during OFC. For multiadministration OFC for wheat, the dosing interval should be longer than 60 min. Our findings can help improve the safety of OFCs.

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Oral food challenge with raw egg: Sixty‐minute‐ compared with 30‐minute dosing interval

Cited by 2 publications

References 9 publications

Management of food allergy based on oral food challenge

Management of food allergy based on oral food challenge

Timing of initial symptom onset during milk and wheat challenges: A retrospective study

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