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Improvement in health-related quality of life in food-allergic patients

Published: June 1, 2021

Food allergy (FA) is a growing health burden worldwide affecting patients’ health related quality of life (HRQoL) due to increased anxiety as well as social and economic restrictions. Dietary avoidance remains the standard of care, except for peanut allergy. Dietary avoidance can be challenging and approximately 40% of patients present with reactions, ranging from mild ones to severe anaphylaxis caused by accidental exposure. Higher levels of anxiety and stress are often found in FA patients and their caregivers. Recent studies show that interventions such as oral food challenges (OFCs) and oral immunotherapy (OIT) have potential benefit in improving HRQoL, however, there is a lack of rigorous HRQoL data and quantitative synthesis.

In a recently published study in The Journal of Allergy and Clinical Immunology: In Practice, Cao et al. conducted a systematic review and quantitative synthesis to assess the potential benefits of interventions for addressing FA to a variety of foods. Authors performed a systematic search using several online publication databases, including PubMed, Cochrane Medical Library and Stanford Lane Medical Library, and performed a meta-analysis focusing on studies assessing changes in HRQoL after OIT and/or OFCs in FA study participants and caregivers from 2010 to July 2020. Over 1000 participants with FA enrolled in 13 studies were included in this systematic review and meta-analysis.

All 7 OIT studies showed a significant improvement on HRQoL scores after OIT compared to baseline. Additionally, on evaluating placebo-controlled studies, participants who received active OIT had a significantly higher improvement in HRQoL scores compared to the placebo groups. Caregivers of pediatric participants also reported an improvement in HRQoL after OIT. Five out of 6 trials including OFCs reported a significant improvement at the time of follow-up; the overall effect showing a trend towards improvement of the HRQoL scores after OFCs. These results are important for FA patients and their caregivers, as well as physicians and researchers.  The results underscore the potential benefits of OIT and OFCs in improving patients’ quality of life, which should be considered when balancing the pros and cons of treatment or diagnostic tests in clinical practice.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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