EAACI Guidelines on allergen immunotherapy: IgE-mediated food allergy

G B Pajno, M Fernandez-Rivas, S Arasi, G Roberts, C A Akdis, M Alvaro-Lozano, K Beyer, C Bindslev-Jensen, W Burks, M Ebisawa, P Eigenmann, E Knol, K C Nadeau, L K Poulsen, R van Ree, A F Santos, G du Toit, S Dhami, U Nurmatov, Y BolohM Makela, L O'Mahony, N Papadopoulos, C Sackesen, I Agache, E Angier, S Halken, M Jutel, S Lau, O Pfaar, D Ryan, G Sturm, E-M Varga, R G van Wijk, A Sheikh, A Muraro, EAACI Allergen Immunotherapy Guidelines Group

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

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.

Original languageEnglish
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume73
Issue number4
Pages (from-to)799-815
ISSN0105-4538
DOIs
Publication statusPublished - Apr 2018

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Food Hypersensitivity
Allergy and Immunology
Guidelines
Allergens
Egg Hypersensitivity
Peanut Hypersensitivity
Quality of Health Care
Advisory Committees
Quality of Life
Food
Research

Keywords

  • adolescent
  • adult
  • allergen immunotherapy
  • allergy
  • food
  • pediatric

Cite this

Pajno, G. B., Fernandez-Rivas, M., Arasi, S., Roberts, G., Akdis, C. A., Alvaro-Lozano, M., ... EAACI Allergen Immunotherapy Guidelines Group (2018). EAACI Guidelines on allergen immunotherapy: IgE-mediated food allergy. Allergy: European Journal of Allergy and Clinical Immunology, 73(4), 799-815. https://doi.org/10.1111/all.13319
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 ; EAACI Allergen Immunotherapy Guidelines Group. / EAACI Guidelines on allergen immunotherapy : IgE-mediated food allergy. In: Allergy: European Journal of Allergy and Clinical Immunology. 2018 ; Vol. 73, No. 4. pp. 799-815.
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abstract = "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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Pajno, GB, Fernandez-Rivas, M, Arasi, S, Roberts, G, Akdis, CA, Alvaro-Lozano, M, Beyer, K, Bindslev-Jensen, C, Burks, W, Ebisawa, M, Eigenmann, P, Knol, E, Nadeau, KC, Poulsen, LK, van Ree, R, Santos, AF, 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, RG, Sheikh, A, Muraro, A & EAACI Allergen Immunotherapy Guidelines Group 2018, 'EAACI Guidelines on allergen immunotherapy: IgE-mediated food allergy', Allergy: European Journal of Allergy and Clinical Immunology, vol. 73, no. 4, pp. 799-815. https://doi.org/10.1111/all.13319

EAACI Guidelines on allergen immunotherapy : IgE-mediated food allergy. / 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; EAACI Allergen Immunotherapy Guidelines Group.

In: Allergy: European Journal of Allergy and Clinical Immunology, Vol. 73, No. 4, 04.2018, p. 799-815.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - EAACI Guidelines on allergen immunotherapy

T2 - IgE-mediated food allergy

AU - Pajno, G B

AU - Fernandez-Rivas, M

AU - Arasi, S

AU - Roberts, G

AU - Akdis, C A

AU - Alvaro-Lozano, M

AU - Beyer, K

AU - Bindslev-Jensen, C

AU - Burks, W

AU - Ebisawa, M

AU - Eigenmann, P

AU - Knol, E

AU - Nadeau, K C

AU - Poulsen, L K

AU - van Ree, R

AU - Santos, A F

AU - du Toit, G

AU - Dhami, S

AU - Nurmatov, U

AU - Boloh, Y

AU - Makela, M

AU - O'Mahony, L

AU - Papadopoulos, N

AU - Sackesen, C

AU - Agache, I

AU - Angier, E

AU - Halken, S

AU - Jutel, M

AU - Lau, S

AU - Pfaar, O

AU - Ryan, D

AU - Sturm, G

AU - Varga, E-M

AU - van Wijk, R G

AU - Sheikh, A

AU - Muraro, A

AU - EAACI Allergen Immunotherapy Guidelines Group

N1 - © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

PY - 2018/4

Y1 - 2018/4

N2 - 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.

AB - 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.

KW - adolescent

KW - adult

KW - allergen immunotherapy

KW - allergy

KW - food

KW - pediatric

U2 - 10.1111/all.13319

DO - 10.1111/all.13319

M3 - Journal article

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Pajno GB, Fernandez-Rivas M, Arasi S, Roberts G, Akdis CA, Alvaro-Lozano M et al. EAACI Guidelines on allergen immunotherapy: IgE-mediated food allergy. Allergy: European Journal of Allergy and Clinical Immunology. 2018 Apr;73(4):799-815. https://doi.org/10.1111/all.13319