Practice Guideline

. 2025 Jan;80(1):14-36.

doi: 10.1111/all.16345. Epub 2024 Oct 30.

EAACI guidelines on the management of IgE-mediated food allergy

Alexandra F Santos^{1

2

3}, Carmen Riggioni^{4

5}, Ioana Agache⁶, Cezmi A Akdis⁷, Mubeccel Akdis⁷, Alberto Alvarez-Perea^{8

9}, Montserrat Alvaro-Lozano^{10

11}, Barbara Ballmer-Weber^{12

13}, Simona Barni¹⁴, Kirsten Beyer¹⁵, Carsten Bindslev-Jensen¹⁶, Helen A Brough^{1

3}, Betul Buyuktiryaki¹⁷, Derek Chu¹⁸, Stefano Del Giacco¹⁹, Audrey Dunn-Galvin^{20

21}, Bernadette Eberlein²², Motohiro Ebisawa²³, Philippe Eigenmann²⁴, Thomas Eiwegger^{25

26

27

28}, Mary Feeney¹, Montserrat Fernandez-Rivas^{29

30}, Alessandro Fiocchi³¹, Helen R Fisher¹, David M Fleischer³², Mattia Giovannini^{14

33}, Claudia Gray^{34

35}, Karin Hoffmann-Sommergruber³⁶, Susanne Halken³⁷, Jonathan O'B Hourihane³⁸, Christina J Jones³⁹, Marek Jutel⁴⁰, Edward F Knol⁴¹, George N Konstantinou⁴², Gideon Lack^{1

2

3}, Susanne Lau¹⁵, Andreina Marques Mejias^{1

3}, Mary Jane Marchisotto^{43

44}, Rosan Meyer^{45

46}, Charlotte G Mortz¹⁶, Beatriz Moya^{47

48}, Antonella Muraro⁴⁹, Caroline Nilsson^{50

51}, Lucila Camargo Lopes de Oliveira⁵², Liam O'Mahony⁵³, Nikolaos G Papadopoulos^{54

55}, Kirsten P Perrett^{56

57

58}, Rachel Peters^{59

60}, Marcia Podesta⁶¹, Lars K Poulsen⁶², Graham Roberts⁶³, Hugh Sampson⁶⁴, Jürgen Schwarze⁶⁵, Peter Smith^{66

67}, Elizabeth Tham^{68

69

70}, Eva Untersmayr⁷¹, Ronald Van Ree⁷², Carina Venter⁷³, Brian Vickery⁷⁴, Berber Vlieg-Boerstra^{75

76

77}, Thomas Werfel⁷⁸, Margitta Worm¹⁵, George Du Toit^{1

3}, Isabel Skypala^{79

80}

Affiliations

¹ Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
² Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK.
³ Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK.
⁴ Division of Immunology and Allergy, The Hospital for Sick Children and the SickKids Food Allergy and Anaphylaxis Program, Toronto, Ontario, Canada.
⁵ Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁶ Faculty of Medicine, Transylvania University, Brasov, Romania.
⁷ Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland.
⁸ Hospital General Universitario Gregorio Marañón, Madrid, Spain.
⁹ Gregorio Marañón Health Research Institute, Madrid, Spain.
¹⁰ Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain.
¹¹ Institut de Recerca Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
¹² Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
¹³ Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
¹⁴ Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy.
¹⁵ Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.
¹⁶ Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark.
¹⁷ Department of Pediatrics, Division of Pediatric Allergy, Koc University School of Medicine, Istanbul, Türkiye.
¹⁸ McMaster University, Hamilton, Canada.
¹⁹ Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy.
²⁰ Paediatrics and Child Health, INFANT Centre, HRB-CRF, University College Cork, Cork, Ireland.
²¹ Paediatrics and Child Health, Royal College of Surgeons in Ireland, Children's Health Ireland, Dublin, Ireland.
²² Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany.
²³ Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Kanagawa, Japan.
²⁴ Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
²⁵ Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria.
²⁶ Department of Pediatric and Adolescent Medicine, University Hospital St. Pölten, St.Pölten, Austria.
²⁷ Translational Medicine Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.
²⁸ Department of Immunology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
²⁹ Allergy Department, Hospital Clinico San Carlos, Madrid, Spain.
³⁰ Facultad de Medicina, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain.
³¹ Allergy Department, Pediatric Hospital Bambino Gesù IRCCS, Rome, Italy.
³² University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.
³³ Department of Health Sciences, University of Florence, Florence, Italy.
³⁴ Red Cross Children's Hospital and Kidsallergy Centre, Cape Town, South Africa.
³⁵ Department of Paediatrics, University of Cape Town, Cape Town, South Africa.
³⁶ Dept. of pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
³⁷ Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
³⁸ Royal College of Surgeons in Ireland and Childrens Health Ireland, Dublin, Ireland.
³⁹ School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
⁴⁰ Department of Clinical Immunology, Faculty of Medicine, Wrocław Medical University; and ALL-MED Medical Research Institute, Wroclaw, Poland.
⁴¹ Department Center of Translational Immunology and Department Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
⁴² Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, Thessaloniki, Greece.
⁴³ EAACI Patient Organisation Committee, Zurich, Switzerland.
⁴⁴ MJM Advisory, New York, New York, USA.
⁴⁵ Dept. Nutrition and Dietetics, Winchester University, Winchester, UK.
⁴⁶ Department of Medicine, KU Leuven, Leuven, Belgium.
⁴⁷ Department of Allergy, Hospital Universitario 12 de Octubre, Madrid, Spain.
⁴⁸ Instituto de Investigación Sanitaria, Hospital 12 de Octubre (imas12), Madrid, Spain.
⁴⁹ Food Allergy Referral Centre, Padua University Hospital, Padua, Italy.
⁵⁰ Department of Clinical Science and Education, Karolinska Institutet, Solna, Sweden.
⁵¹ Sachs Children and Youth Hospital, South Hospital, Stockholm, Sweden.
⁵² Division of Allergy and Clinical Immunology, Department of Paediatrics, Federal University of São Paulo, São Paulo, Brazil.
⁵³ Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland.
⁵⁴ Allergy Dpt, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
⁵⁵ Lydia Becker Institute, University of Manchester, Manchester, UK.
⁵⁶ Population Allergy, Murdoch Children's Research Institute, Parkville, Australia.
⁵⁷ Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
⁵⁸ Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia.
⁵⁹ Murdoch Children's Research Institute, Parkville, Victoria, Australia.
⁶⁰ Department of Paediatrics, the University of Melbourne, Parkville, Victoria, Australia.
⁶¹ European Federation of Allergy and Airways Diseases Patients' Associations and the EAACI Patient Organisation Committee, Zurich, Switzerland.
⁶² Allergy Clinic, Copenhagen University Hospital at Herlev-Gentofte, Copenhagen, Denmark.
⁶³ Paediatric Allergy and Respiratory Medicine, University of Southampton, NIHR Southampton Biomedical Research Centre and David Hide Asthma and Allergy Centre, St Mary Hospital, Isle of Wight, UK.
⁶⁴ Department of Pediatrics, Division of Allergy and Immunology, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁶⁵ Child Life and Health, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK.
⁶⁶ Clinical Medicine, Griffith University, Southport, Queensland, Australia.
⁶⁷ Queensland Allergy Services Private Practice, Southport, Queensland, Australia.
⁶⁸ Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁶⁹ Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore, Singapore.
⁷⁰ Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁷¹ Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
⁷² Department of Experimental Immunology and of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
⁷³ Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado, Boulder, Colorado, USA.
⁷⁴ Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
⁷⁵ Department of Paediatrics, OLVG Hospital, Amsterdam, the Netherlands.
⁷⁶ Rijnstate Allergy Centre, Rijnstate Hospital, Arnhem, The Netherlands.
⁷⁷ Vlieg Dieticians, Private Practice for dietary management of food allergy, Arnhem, the Netherlands.
⁷⁸ Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
⁷⁹ Part of Guys and St Thomas NHS Foundation Trust, Royal Brompton and Harefield Hospitals, London, UK.
⁸⁰ Department of Inflammation and Repair, Imperial College, London, UK.

PMID: 39473345
PMCID: PMC11724237
DOI: 10.1111/all.16345

Practice Guideline

EAACI guidelines on the management of IgE-mediated food allergy

Alexandra F Santos et al. Allergy. 2025 Jan.

. 2025 Jan;80(1):14-36.

doi: 10.1111/all.16345. Epub 2024 Oct 30.

Authors

Affiliations

¹ Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
² Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK.
³ Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK.
⁴ Division of Immunology and Allergy, The Hospital for Sick Children and the SickKids Food Allergy and Anaphylaxis Program, Toronto, Ontario, Canada.
⁵ Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁶ Faculty of Medicine, Transylvania University, Brasov, Romania.
⁷ Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland.
⁸ Hospital General Universitario Gregorio Marañón, Madrid, Spain.
⁹ Gregorio Marañón Health Research Institute, Madrid, Spain.
¹⁰ Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain.
¹¹ Institut de Recerca Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
¹² Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
¹³ Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
¹⁴ Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy.
¹⁵ Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.
¹⁶ Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark.
¹⁷ Department of Pediatrics, Division of Pediatric Allergy, Koc University School of Medicine, Istanbul, Türkiye.
¹⁸ McMaster University, Hamilton, Canada.
¹⁹ Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy.
²⁰ Paediatrics and Child Health, INFANT Centre, HRB-CRF, University College Cork, Cork, Ireland.
²¹ Paediatrics and Child Health, Royal College of Surgeons in Ireland, Children's Health Ireland, Dublin, Ireland.
²² Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany.
²³ Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Kanagawa, Japan.
²⁴ Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
²⁵ Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria.
²⁶ Department of Pediatric and Adolescent Medicine, University Hospital St. Pölten, St.Pölten, Austria.
²⁷ Translational Medicine Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.
²⁸ Department of Immunology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
²⁹ Allergy Department, Hospital Clinico San Carlos, Madrid, Spain.
³⁰ Facultad de Medicina, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain.
³¹ Allergy Department, Pediatric Hospital Bambino Gesù IRCCS, Rome, Italy.
³² University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.
³³ Department of Health Sciences, University of Florence, Florence, Italy.
³⁴ Red Cross Children's Hospital and Kidsallergy Centre, Cape Town, South Africa.
³⁵ Department of Paediatrics, University of Cape Town, Cape Town, South Africa.
³⁶ Dept. of pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
³⁷ Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
³⁸ Royal College of Surgeons in Ireland and Childrens Health Ireland, Dublin, Ireland.
³⁹ School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
⁴⁰ Department of Clinical Immunology, Faculty of Medicine, Wrocław Medical University; and ALL-MED Medical Research Institute, Wroclaw, Poland.
⁴¹ Department Center of Translational Immunology and Department Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
⁴² Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, Thessaloniki, Greece.
⁴³ EAACI Patient Organisation Committee, Zurich, Switzerland.
⁴⁴ MJM Advisory, New York, New York, USA.
⁴⁵ Dept. Nutrition and Dietetics, Winchester University, Winchester, UK.
⁴⁶ Department of Medicine, KU Leuven, Leuven, Belgium.
⁴⁷ Department of Allergy, Hospital Universitario 12 de Octubre, Madrid, Spain.
⁴⁸ Instituto de Investigación Sanitaria, Hospital 12 de Octubre (imas12), Madrid, Spain.
⁴⁹ Food Allergy Referral Centre, Padua University Hospital, Padua, Italy.
⁵⁰ Department of Clinical Science and Education, Karolinska Institutet, Solna, Sweden.
⁵¹ Sachs Children and Youth Hospital, South Hospital, Stockholm, Sweden.
⁵² Division of Allergy and Clinical Immunology, Department of Paediatrics, Federal University of São Paulo, São Paulo, Brazil.
⁵³ Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland.
⁵⁴ Allergy Dpt, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
⁵⁵ Lydia Becker Institute, University of Manchester, Manchester, UK.
⁵⁶ Population Allergy, Murdoch Children's Research Institute, Parkville, Australia.
⁵⁷ Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
⁵⁸ Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia.
⁵⁹ Murdoch Children's Research Institute, Parkville, Victoria, Australia.
⁶⁰ Department of Paediatrics, the University of Melbourne, Parkville, Victoria, Australia.
⁶¹ European Federation of Allergy and Airways Diseases Patients' Associations and the EAACI Patient Organisation Committee, Zurich, Switzerland.
⁶² Allergy Clinic, Copenhagen University Hospital at Herlev-Gentofte, Copenhagen, Denmark.
⁶³ Paediatric Allergy and Respiratory Medicine, University of Southampton, NIHR Southampton Biomedical Research Centre and David Hide Asthma and Allergy Centre, St Mary Hospital, Isle of Wight, UK.
⁶⁴ Department of Pediatrics, Division of Allergy and Immunology, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁶⁵ Child Life and Health, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK.
⁶⁶ Clinical Medicine, Griffith University, Southport, Queensland, Australia.
⁶⁷ Queensland Allergy Services Private Practice, Southport, Queensland, Australia.
⁶⁸ Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁶⁹ Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore, Singapore.
⁷⁰ Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁷¹ Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
⁷² Department of Experimental Immunology and of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
⁷³ Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado, Boulder, Colorado, USA.
⁷⁴ Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
⁷⁵ Department of Paediatrics, OLVG Hospital, Amsterdam, the Netherlands.
⁷⁶ Rijnstate Allergy Centre, Rijnstate Hospital, Arnhem, The Netherlands.
⁷⁷ Vlieg Dieticians, Private Practice for dietary management of food allergy, Arnhem, the Netherlands.
⁷⁸ Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
⁷⁹ Part of Guys and St Thomas NHS Foundation Trust, Royal Brompton and Harefield Hospitals, London, UK.
⁸⁰ Department of Inflammation and Repair, Imperial College, London, UK.

PMID: 39473345
PMCID: PMC11724237
DOI: 10.1111/all.16345

Abstract

This European Academy of Allergy and Clinical Immunology (EAACI) guideline provides recommendations for the management of IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Following the confirmation of IgE-mediated food allergy diagnosis, allergen avoidance and dietary advice (with support of a specialised dietitian, if possible) together with the provision of a written treatment plan, education on the recognition of allergic symptoms and prescription of medication including adrenaline using an auto-injector are essential. Patients with significant anxiety and requirement for coping strategies may benefit from support from a clinical psychologist. As immunomodulatory interventions, omalizumab is suggested for treatment of IgE-mediated food allergy in children from the age of 1 and adults; and oral allergen-specific immunotherapy is recommended for children and adolescents with peanut allergy and suggested for milk and egg allergies (generally after 4 years of age for milk and egg). Sublingual and epicutaneous immunotherapy are suggested for peanut allergy but are not yet available at the point of care. Future research into disease modifying treatments for IgE-mediated food allergy are highly needed, with standardised and patient-focused protocols and outcomes.

Keywords: IgE‐mediated food allergy; allergen immunotherapy; anaphylaxis; biologicals; diet; food allergy; management; treatment.

PubMed Disclaimer

Conflict of interest statement

The EAACI Food Allergy Guidelines were commissioned and funded by EAACI to support the effort towards the systematic review of the literature and meta‐analyses. All members of the steering committee and of the expert group worked voluntarily without compensation and filled in a declaration of conflicts ahead of the start of the project, which were reviewed by EAACI.

A.F. Santos reports grants from Medical Research Council (MR/M008517/1; MC/PC/18052; MR/T032081/1), Food Allergy Research and Education (FARE), the Immune Tolerance Network/National Institute of Allergy and Infectious Diseases (NIAID, NIH), Asthma UK (AUK‐BC‐2015‐01), BBSRC, Rosetrees Trust and the NIHR through the Biomedical Research Centre (BRC) award to Guy's and St Thomas' NHS Foundation Trust, during the conduct of the study; personal fees from Thermo Scientific, Nutricia, Infomed, Novartis, Allergy Therapeutics, Buhlmann, as well as research support from Buhlmann and Thermo Fisher Scientific through a collaboration agreement with King's College London. C. Riggioni reports academic grants for the study of immunotherapy in food allergic children from the Spanish Society of Paediatric Allergy (SEICAP) and the National University of Singapore. H. A. Brough reports research grants from NIH (NAIAD), Aimmune and DBV Technologies, and speaker honoraria fees from DBV Technologies, GSK and Sanofi outside of the submitted work. I. Agache reports Deputy Editor Allergy and Associate Editor Clinical and Translational Allergy. A. Fiocchi reports research grants from Ferrero, Hipp, Sanofi, Novartis, Astrazeneca and DBV, fees for presentations and advisory boards for Danone, Abbott, Ferrero, Stallergenes and Novartis. H. Fisher reports employment at Sanofi, outside of the submitted work. D. Fleischer reports research grants to institution from ARS Pharmaceuticals and DBV Technologies; unpaid advisory board member for Food Allergy & Anaphylaxis Connection Team and the National Peanut Board; royalties from UpToDate; consultation fees as a member of physician/medical advisory boards to Aquestive, ARS Pharmaceuticals, Bryn Pharma, DBV Technologies, Genentech, and Nasus; and speaker fees from Genentech, outside the submitted work. B. Ballmer‐Weber reports personal fees for presentations and advisory boards from Thermo Fisher Scientific, Novartis, ALK, Allergopharma, Menarini, Sanofi, MSD, Aiummune. S. Halken reports personal fees from ALK, personal fees from Mead Johnson, personal fees from Viatris, personal fees from GSK, outside the submitted work. S. Lau receives grants from Novartis, DBV, Infectopharm as deputy PI and a grant from the German Research Foundation (DFG). SL received personal fees from Allergopharma, ALK, Viatris, Lilly, DBV, GSK, Leo Pharma and Sanofi‐Aventis. P. Smith has received investigator initiated funding from GSK, Hyloris and Sanofi. C. G Mortz report research grant from Novartis and Thermo Fisher Scientific. B. Eberlein reports research support from Bühlmann. D. Fleisher reports Grant/research support: Aimmune Therapeutics, DBV Technolgies. Consultant: Aquestive Therapeutics, ARS Pharma, DBV Technologies, Nasus Pharma Genentech’ Royalties: UpToDate. M. Jutel reports: Personal fees form Allergopharma, ALK‐Abello, Stallergenes, Anergis, Allergy Therapeutics, Leti, HAL, GSK, Novartis, Teva, Takeda, Chiesi, Pfizer, Regeneron, Astra‐Zeneka, Lallemand, Shire, Celltrion Inc., Genentech, Roche, Verona, Lek Pharmaceuticals, Arcutis Biotherapeutics, FAES FARMA outside of submitted work. Deputy Editor in chief Allergy, Associate Editor CTA. C. Bindslev‐Jensen reports material for IgE analyzes from Thermofisher; Lecture fee from Alk‐Abello; advisory board fees from ALK and Novartis research grants from Ionis, Allakos, Novartis. E. F. Knol reports Research grants from Stichting Astma Bestrijding and European Union. Research support from Euroimmune, speakers fee from Thermo Fisher Scientific, Hycor, Sanofi and GSK. C. Jones reports Research grants from the National Institute for Health and Care Research, Food Standards Agency and honoraria from National Institute for Health and Care Research, Allergy UK and Danone/Nutricia. C. Gray reports speaker or advisory board fees from Nutricia, Thermofisher, Kenvue, Viatris and Sanofi. G. Du Toit reports grants and personal fees from Aimmune, grants and personal fees from DBV, personal fees from FARE, grants from NIH‐NIAID, grants and personal fees from Novartis, outside the submitted work. G. Roberts reports Research funding from National Institute of Health and Food Standards Agency. President of British Society of Allergy and Clinical Immunology.

H. Sampson reports funding to his institution for grants from NIH/NIAID and has received consulting fees from DBV Technologies, S. A., N‐Fold Therapeutics, LLC, and Siolta, Inc., and stock options from DBV Technologies and N‐Fold Therapeutics. S. Del Giacco has received speaker and consultancy fees from AstraZeneca, Chiesi, CSL‐Behring, GSK, Novartis, Sanofi, Stallergenes and unrestricted research grants from Novartis and GSK, all outside this work. G. N. Konstantinou is or recently was a speaker and/or advisor for and/or has received research funding from AstraZeneca, Chiesi, GSK, Menarini, Novartis, Nutricia, Pfizer, Sanofi, Takeda, TEVA and Vianex. C. Nilsson reports grants to institution from Aimmune Therapeutics a Nestlé Company, Lecture fees from ALK, Themofisher, GSK. A. Muraro declared the receipt of consultation or speakers' fees for Viatris, Aimmune, DVB Technologies, Nestlè Health Sciences, ALK, Stallergenes, Novartis, Sanofi. Regeneron. E. Untersmayr reports grants from Desentum Oy; and received personal speaker fees from Nutrica, AllergoPharma, MacroArray Diagnostics. B. P. Vickery reports grants from Abbott, grants and personal fees from Aimmune, grants from Alladapt, personal fees from AllerGenis, personal fees from Aravax, grants and personal fees from DBV, grants and personal fees from FARE, grants from Genentech, stock options from Moonlight Therapeutics, grants from NIH‐NIAID, grants and personal fees from Novartis, personal fees from Reacta Biosciences, grants and personal fees from Regeneron, personal fees from Sanofi, grants from Siolta, outside the submitted work. M. Worm declares the receipt of honoraria or consultation fees by the following companies: Novartis Pharma GmbH, Sanofi‐Aventis Deutschland GmbH, DBV Technologies S.A, Aimmune Therapeutics UK Limited, Regeneron Pharmaceuticals, Inc., Leo Pharma GmbH, Boehringer Ingelheim Pharma GmbH &Co.KG, ALK‐Abelló Arzneimittel GmbH, Lilly Deutschland GmbH, Kymab Limited, Amgen GmbH, Abbvie Deutschland GmbH & Co. KG, Pfizer Pharma GmbH, Mylan Germany GmbH (A Viatris Company), AstraZeneca GmbH, Lilly Deutschland GmbH and GlaxoSmithKline GmbH & Co. KG. B. Vlieg–Boerstra received research funding from Nutricia, consulting or speaker's fees from Marfo Food groups, Nestlé, Abbott, Nutricia and Vinimini. J. Schwarze reports personal consulting fees from Aimmune and Sanofi, congress sponsorship from ALK, research grants from NIHR and UKRI‐MRC. K. Hoffmann‐Sommergruber reports grant support from Government of Lower Austria (DARC) and consultancy fees from COMPARE Database. K. Beyer reports grants from the German Research Foundation, the Federal Ministry of Education and Research, the Federal Ministry of Food and Agriculture as well as from Aimmune, Danone/Nutricia, DBV, Hipp, Hycor, Infectopharm and Novartis; she received personal fees from Aimmune, Akademie Fresenius, Allergy Therapeutics, ALK, Danone/Nutricia, Hipp, Hycor, Infectopharm, Kantar Health, Limbach Gruppe, Mylan/Meda/Mice, Nestle, Novartis, Sonic Health Care and ThermoFisher. K. P. Perrett has received research grants from National Health & Medical Research Council of Australia, Immune Tolerance Network (NIH), Aravax, DBV Technologies, Novartis and Siolta and consultant fees from Aravax, paid to their institution, outside the submitted work. L. O'Mahony reports Consultancy with Precision BioticsAlimentary Health, grants from GlaxoSmithKline and Chiesi, and participation in speaker bureau for Nestle, Yakult, Reckitt and Abbott. L. Oliveira reports Speakers fee from Thermo Fisher Scientific, Nutricia, Sanofi and Takeda. Dunn‐Galvin declares the receipt of honoraria or consultation fees from Novartis, DBV, Aimmune, Nestle. M. Alvaro‐Lozano reports Honoraria or consultation fees from ALK‐Abello, FAES Pharma, LETI Pharma, Merck, Aimmune, DBV Technologies, Allergy Therapeutics, Stallergenes, Diater, Novartis, Uriach, Nestle and Sanofi Genzyme. Grants from SEICAP, SCAIC. M. Fernandez‐Rivas reports research support from Instituto de Salud Carlos III, Spanish Government, Aimmune Therapeutics, Diater and Novartis; Speaker and Advisory Board honoraria from Aimmune Therapeutics, DBV, Diater, Ediciones Mayo, EPG Health, GSK, HAL Allergy, MEDSCAPE; Novartis, Reacta Healthcare, SPRIM. M. Ebisawa reports Speaker and Advisory Board honoraria from Viatris, Novartis, Sanofi, and ARS‐Pharmaceuticals. M. Marshisotto reports advisory roles to IFPIES, National Peanut Board, Novartis Patient Advisory Board, GA2LEN ANACare and University of Michigan. N. Papadoupoulos reports Research Support from Capricare, Nestle, Numil, REG, Vianex. Speaker and Advisory Board honoraria from Abbott, Abbvie, Astra Zeneca, GSK, HAL, Medscape, Menarini/Faes Farma, Mylan, Novartis, Nutricia, OM Pharma, Regeneron/Sanofi. P. Smith reports Speaker and advisory board honoraria from Nestle Nutrition Institute. Investigator initiated research funding from GSK and Sanofi. Vitaris advisory board honoraria. P. Eigenmann reports Speaker and advisory board honoraria: DBV technologies, Novartis, ThermoFisher Scientific, Nestlé Health Sciences, Synlab, GSK; Stocks and Stock options: DBV technologies. R. Peters reports research grants from the National Health & Medical Research Council of Australia, and research support from ThermoFisher, paid to their institution, outside the submitted work. R. van Ree reports Consultancies for HAL Allergy, Citeq, Angany, Reacta Helathcare, Mission MightMe, AB Enzymes, The Protein Brewery; speaker's fees from HAL Allergy, ALK and Thermo Fisher Scientific; stock options from Angany. R. Meyer honoraria from academic lectures and consultancy fees from Nutricia/Danone, Abbott Laboratories, Nestle Clinical Nutrition, Reckitt Benckiser and Else Nutrition. T. Eiwegger reports to act/recently acted as local PI for company sponsored trials by DBV Therapeutics, Greer Stallergens, and sub‐investigator for Regeneronand ALK‐Abelló. He/his lab received unconditional/in‐kind contributions from Macro Array. Diagnostics and ALK‐Abelló and he is co‐I in an investigator‐initiated trial with in‐kind support from Novartis. He holds advisory board roles for ALK‐Abelló, and Nutricia/Danone. TE reports lecture fees from Novartis, ThermoFisher, Nutricia/Danone, MADX, ALK‐Abelló. T. Werfel has received institutional grants from LEO Pharma and Novartis, has performed consultancies for Abbvie, Almirall, Janssen, Galderma, LEO, Lilly, Novartis, Pfizer, Sanofi‐Regeneron and has lectured at events sponsored by Abbvie, Janssen, Celgene, Galderma, LEO Pharma, Lilly, Sanofi and Novartis. I. Skypala—honoraria from ThermoFisher, Royal College of General Practitioners and Touch Independent Medical Education. JOBH declares research funding from DBV Technologies, Johnson& Johnson, Consultancy with Camallergy, speaker fees from Nutricia. A. Alvarez‐Perea declares the receipt of honoraria or consultation fees from ALK‐Abelló, Organon, Immunotek, DBV‐technologies, GSK and PI and sub‐investigator for company sponsored trials by Novartis, Leti, CEU‐San Pablo, Aimmune. The other authors have nothing to disclose.

Figures

**FIGURE 1**
Management of IgE‐mediated food allergy.

See this image and copyright information in PMC

Cited by

Food Allergy Prevalence and Characteristics Among Adults in Cyprus: Effects on Health-Related Quality of Life.
Nicolaou SA, Pham ATA, Alexandrou A, Andreou E, Papanastasiou EC, Nicolaou N. Nicolaou SA, et al. Nutrients. 2025 Jun 18;17(12):2028. doi: 10.3390/nu17122028. Nutrients. 2025. PMID: 40573141 Free PMC article.
Advances in Shellfish Allergy Therapy: From Current Approaches to Future Strategies.
Heidari S, Ruethers T, Karnaneedi S, Yin LWS, Lopata AL. Heidari S, et al. Clin Rev Allergy Immunol. 2025 Jul 16;68(1):65. doi: 10.1007/s12016-025-09077-8. Clin Rev Allergy Immunol. 2025. PMID: 40668267 Free PMC article. Review.
Self-reported accidental allergic reactions among patients with challenge-verified food allergy.
Svendsen SV, Senders AS, Oropeza AR, Lassen A, Bindslev-Jensen C, Mortz CG. Svendsen SV, et al. Clin Transl Allergy. 2025 Jun;15(6):e70067. doi: 10.1002/clt2.70067. Clin Transl Allergy. 2025. PMID: 40533194 Free PMC article.
Predicting Tolerance to Cow's Milk Allergy in Children Using IgE and IgG4 Peptide Binding Profiles.
Fernández-Lozano C, Olmos-Piñero S, Sánchez-Ruano L, Terrados S, Diéguez MDC, Fernández-Rivas M, Vlaicu C, Cerecedo I, Gonzalo-Fernandez A, de la Hoz B, Martínez-Botas J. Fernández-Lozano C, et al. Cells. 2025 Feb 27;14(5):344. doi: 10.3390/cells14050344. Cells. 2025. PMID: 40072073 Free PMC article.
Managing Food Allergies in Dining Establishments: Challenges and Innovative Solutions.
Konstantinou GN, Pampoukidou O, Sergelidis D, Fotoulaki M. Konstantinou GN, et al. Nutrients. 2025 May 20;17(10):1737. doi: 10.3390/nu17101737. Nutrients. 2025. PMID: 40431476 Free PMC article. Review.

See all "Cited by" articles

References

1. Gupta RS, Warren CM, Smith BM, et al. Prevalence and Severity of Food Allergies Among US Adults. JAMA Netw Open. 2019;2(1):e185630. doi:10.1001/jamanetworkopen.2018.5630 - DOI - PMC - PubMed
1. Gupta RS, Warren CM, Smith BM, et al. The Public Health Impact of Parent‐Reported Childhood Food Allergies in the United States. Pediatrics. 2018;142(6). doi:10.1542/peds.2018-1235 - DOI - PMC - PubMed
1. Rona RJ, Keil T, Summers C, et al. The prevalence of food allergy: a meta‐analysis. J Allergy Clin Immunol. 2007;120(3):638‐646. doi:10.1016/j.jaci.2007.05.026 - DOI - PubMed
1. Halken S, Muraro A, de Silva D, et al. EAACI guideline: Preventing the development of food allergy in infants and young children (2020 update). Pediatr Allergy Immunol. 2021;32(5):843‐858. doi:10.1111/pai.13496 - DOI - PubMed
1. Muraro A, Werfel T, Hoffmann‐Sommergruber K, et al. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014;69(8):1008‐1025. doi:10.1111/all.12429 - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions
Actions

Grants and funding

European Academy of Allergy and Clinical Immunology

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

EAACI guidelines on the management of IgE-mediated food allergy

Affiliations

EAACI guidelines on the management of IgE-mediated food allergy

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials