The Psychosocial Burden of Food Allergy Among Adults: A US Population-Based Study

Warren, Christopher; Dyer, Ashley; Lombard, Lisa; DunnGalvin, Audrey; Gupta, Ruchi S.

doi:10.1016/j.jaip.2021.02.039

Cited by 31 publications

(27 citation statements)

References 30 publications

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“…Around 6% of people live with immunoglobulin E (IgE)-mediated food allergy 1 which affects quality of life, social activities, anxiety and nutrition. 2,3 Patients are advised to avoid the allergen and use medications to relieve symptoms, but accidental exposure is common and can be life-threatening. 4 There is growing interest in allergen-specific immunotherapy (hereafter immunotherapy) and biological therapies.…”

Section: Introductionmentioning

confidence: 99%

Allergen immunotherapy and/or biologicals for IgE‐mediated food allergy: A systematic review and meta‐analysis

Silva

Río

Jong

et al. 2022

Allergy

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Background There is substantial interest in immunotherapy and biologicals in IgE‐mediated food allergy. Methods We searched six databases for randomized controlled trials about immunotherapy alone or with biologicals (to April 2021) or biological monotherapy (to September 2021) in food allergy confirmed by oral food challenge. We pooled the data using random‐effects meta‐analysis. Results We included 36 trials about immunotherapy with 2126 mainly child participants. Oral immunotherapy increased tolerance whilst on therapy for peanut (RR 9.9, 95% CI 4.5.–21.4, high certainty); cow's milk (RR 5.7, 1.9–16.7, moderate certainty) and hen's egg allergy (RR 8.9, 4.4–18, moderate certainty). The number needed to treat to increase tolerance to a single dose of 300 mg or 1000 mg peanut protein was 2. Oral immunotherapy did not increase adverse reactions (RR 1.1, 1.0–1.2, low certainty) or severe reactions in peanut allergy (RR 1,6, 0.7–3.5, low certainty), but may increase (mild) adverse reactions in cow's milk (RR 3.9, 2.1–7.5, low certainty) and hen's egg allergy (RR 7.0, 2.4–19.8, moderate certainty). Epicutaneous immunotherapy increased tolerance whilst on therapy for peanut (RR 2.6, 1.8–3.8, moderate certainty). Results were unclear for other allergies and administration routes. There were too few trials of biologicals alone (3) or with immunotherapy (1) to draw conclusions. Conclusions Oral immunotherapy improves tolerance whilst on therapy and is probably safe in peanut, cow's milk and hen's egg allergy. More research is needed about quality of life, cost and biologicals.

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Section: Introductionmentioning

confidence: 99%

Allergen immunotherapy and/or biologicals for IgE‐mediated food allergy: A systematic review and meta‐analysis

Silva

Río

Jong

et al. 2022

Allergy

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Section: Introductionmentioning

confidence: 99%

“…Immunoglobulin E (IgE)‐mediated food allergy can have a significant impact on people's quality of life, social interactions and nutrition, with a risk of fatal allergic reactions. 1 Few treatments are available. People are often advised to avoid the allergen, take medication to reduce symptoms and carry adrenaline in case of an anaphylactic reaction.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of monotherapy with biologicals for children and adults with IgE‐mediated food allergy

Silva¹,

Singh²,

Arasi

et al. 2022

Clinical & Translational All

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Background Biological therapies relieve symptoms in allergic inflammatory diseases so we systematically reviewed the evidence about whether biological monotherapy could benefit people with IgE‐mediated food allergy. Methods We searched six bibliographic databases from 1946 to 30 September 2021 for randomised and non‐randomised controlled trials about biological monotherapy in people with IgE‐mediated food allergy confirmed by oral food challenge. We used the Grading of Recommendations, Assessment, Development and Evaluation approach to narratively summarise findings from three trials with 118 participants. The studies were too heterogeneous and sparse to conduct meta‐analysis. Results We included one randomised trial about etokimab, one about omalizumab and one about the discontinued TNX‐901. All were in people with peanut allergy in the USA, mostly aged 13+ years. There was a trend towards improved tolerance of peanut during treatment, with few side effects. However, we have very low certainty about the evidence due to the small number of trials and participants. No included trial reported on quality of life or cost‐effectiveness. Conclusions There is not yet enough certainty to support offering etokimab or omalizumab widely for food allergy. Clinicians may consider the merits for individuals, but large randomised trials with standardised measures are needed to confirm the safety, efficacy and most suitable candidates, doses and durations of treatment before more universal use.

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“…This includes higher rates of physician-confirmed IgE-FA diagnosis, EAI prescriptions, diagnostic testing, and ED visits, all of which support previous research showing that adults with adult-onset IgE-FA have lower levels of health care usage. 16 While this variation in health care usage may reflect trends in severity (real or perceived), it also may be affected by the low rate of adults with a convincing IgE-FA who have a physician-diagnosed IgE-FA. 1 Because only approximately half of adults with IgE-FA received a physician-confirmed IgE-FA diagnosis, 1 it is possible that the low levels of health care utilization among adults with adult-onset IgE-FA are related to a lack of patient knowledge of IgE-FA diagnosis and management, a lack of accessibility/availability to specialty care, or a lack of effective communication between patient and provider regarding symptom severity.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study characterized the psychosocial burden of IgE-FA among a population-based sample of US adults and found specific demographic characteristics and allergic conditions to be associated with increased psychosocial burden. 16 While this study suggested that certain aspects of health care utilization, such as EAI prescriptions and ED visits, were associated with a greater IgE-FA–related psychosocial burden among the population of adults with IgE-FA, 16 the research remains mixed. One study exploring specific factors that affect QoL in children and adults with IgE-FA found no association between current EAI prescriptions and QoL impairment.…”

mentioning

confidence: 92%

Phenotypic characterization of childhood- and adult-onset food allergy among adults in the United States

Hultquist

Dyer

Jiang

et al. 2022

Journal of Allergy and Clinical Immunology: Global

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The Psychosocial Burden of Food Allergy Among Adults: A US Population-Based Study

Cited by 31 publications

References 30 publications

Allergen immunotherapy and/or biologicals for IgE‐mediated food allergy: A systematic review and meta‐analysis

Allergen immunotherapy and/or biologicals for IgE‐mediated food allergy: A systematic review and meta‐analysis

Systematic review of monotherapy with biologicals for children and adults with IgE‐mediated food allergy

Phenotypic characterization of childhood- and adult-onset food allergy among adults in the United States

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