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Review
. 2023 Jan;53(1):25-38.
doi: 10.1111/cea.14241. Epub 2022 Oct 19.

Management of IgE-mediated food allergy in the 21st century

Arianna Cafarotti  1 , Mattia Giovannini  2 , Philippe Begìn  3   4 , Helen A Brough  5   6 , Stefania Arasi  1
Affiliations
Review

Management of IgE-mediated food allergy in the 21st century

Arianna Cafarotti et al. Clin Exp Allergy. 2023 Jan.

Abstract

The 21st century has seen the propulsion of research in the field of food allergy, which has driven real changes in the clinical approach. Allergen immunotherapy has been recommended for the active management of food allergy. Data have shown promising additional methods of treatment, including biologics. Efforts have been devoted to the risk stratification of food allergy and the standardization of the assessment of food-allergic severity. Alternative routes of administration of epinephrine are under investigation to minimize any mechanical issue and the fear of injections. Evidence-based guidelines have been published by the main international societies in the field of anaphylaxis and food allergy management and new updates are in preparation. In the coming years, treatment options that are currently in pre-clinical or early clinical evaluation will hopefully lead to safe and effective disease-modifying therapies for food allergy in clinical practice. The identification of reliable biomarkers and the standardization of definitions and measurement approaches, alongside a shared decision-making with patients and families, will be key for the development of personalized care and to help minimize the substantial burden of food allergy.

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Conflict of interest statement

HB reports grant from National Institute of Allergy and Infectious Diseases (NIAID, NIH), and speaker honoraria from DBV Technologies, GSK and Sanofi. PB reports grant from Canadian Institutes of Health Research and the Fonds de Recherche du Québec ‐ Santé, Novartis, Sanofi, Regeneron and DBV technologies as well as personal fees from Novartis, Sanofi‐Genzyme, DBV technologies, Aralez, ALK, Pfizer, Astra‐Zeneca and Bausch Health outside the submitted work. SA has participated as an advisory board member, and/or consultant, and/or speaker for Aimmune, Novartis, and Ulrich outside the submitted work. AC and MG declare no conflicts of interest inherent to this paper.

Figures

FIGURE 1
FIGURE 1
Multidisciplinary integrated care in food allergy—adapted from EAACI guidelines for the management of patients with allergies.
FIGURE 2
FIGURE 2
Milestones in the management of food allergy in the 21st century. DBPCFC, double‐blind placebo‐controlled food challenge; DRACMA, Diagnosis and Rationale for Action against Cow's Milk Allergy; EMS, Emergency Medical Services; EAACI, European Academy of Allergy and Clinical Immunology; FA, food allergy; FAQLQ, Food Allergy Quality of Life Questionnaires; FA‐HRQL, Food Allergy Health Related Quality of Life; FDA, Food and Drug Administration; HRQL, Health Related Quality of Life; OFC, oral food challenge; OIT, oral immunotherapy; OMA, omalizumab; PANAS, Positive and Negative Affect Schedule; pts, patients; POIT, peanut oral immunotherapy; SU, sustained unresponsiveness.
See this image and copyright information in PMC

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