Published online: July 6, 2018
Food allergy is a major worldwide health problem. The elimination diet, which has been the traditional treatment approach in patients with food allergy, is hampered by adverse reactions due to accidental exposures and is associated with significantly impaired quality of life (QOL). Treatment of food allergy in the form of oral immunotherapy (OIT), while effective, is associated with adverse effects, some requiring epinephrine and with the need to consume a daily dose to which patients may react or find burdensome.
In a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, Epstein-Rigbi and colleagues examined the impact of the different phases of OIT on patients’ QOL. The Food Allergy Quality of Life Questionnaire-Parental Form (FAQLQ-PF) was administered to parents of 191 consecutive children aged 4-12 years, undergoing OIT for allergies to milk, egg, peanuts, sesame, and tree nuts and to 48 children with food allergies treated with elimination diet. Questionnaires were administered at OIT initiation, when patients were half-way through treatment, when patients reached their maintenance dose, and after 6 months of daily dose consumption.
QOL significantly improved during OIT for patients who reached the full dose and even in those who reached just a partial maintenance dose, but not in patients who remained on the elimination diet. QOL deteriorated in some patients while they were half-way through treatment, but then improved when they reached the maintenance dose. An additional significant improvement in QOL was noted after 6 months of daily dose consumption.
The authors concluded that OIT has significant progressive beneficial effects on the QOL of food-allergic patients, benefits which should be considered when balancing the pros and cons of OIT.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.
Quality of life of food-allergic patients before, during and following oral immunotherapy
By Na'ama Epstein-Rigbi, Michael R Goldberg, Michael B Levy, Liat Nachshon, Arnon Elizur