Early peanut introduction associated with decreasing rates of anaphylaxis
Published online June 11, 2024
Food allergies have increased significantly in the past decade in North America. In particular, peanut allergy is the most common food allergy in children and a leading cause of anaphylaxis, a life-threatening allergic reaction. In 2017, new guidelines for early introduction of peanuts to infants around 6 months of age were implemented – prior to this, the recommendation in Canada was to delay until 3 years of age. While early allergen introduction during infancy has emerged as a potential preventive strategy, the precise effect of these new recommendations on rates of anaphylaxis in Canada had never been evaluated before.
In this study published in The Journal of Allergy and Clinical Immunology: In Practice, Yu et al. analyzed the number of children with and without known peanut allergy who presented to the Montreal Children’s Hospital (MCH) Emergency Department (ED) for anaphylaxis to peanuts between 2011 and 2019. Data from 2020 onward was excluded due to the COVID-19 pandemic. Of the 429 patients identified, 180 (42%) had no known peanut allergy, compared to 249 (58%) with already known peanut allergy. The rate of peanut-induced anaphylaxis presentations to the ED per 100,000 people visiting the ED for any reason were calculated in 4-month intervals. Using a technique called interrupted time series analysis, the team compared the trend of anaphylaxis rates before and after 2017 for children ages zero to two and three to seventeen years of age. They hypothesized that for children ages zero to two, who could have benefited from the early introduction of peanuts as of 2017, there would be a downtrend in the rates of anaphylaxis after 2017. In contrast, they hypothesized children ages three to seventeen would not show any significant changes, as they would have missed their chance for early peanut introduction after 2017.
The team found a significant decrease in the rates of anaphylaxis after 2017 in children ages two and under without previously known peanut allergy. No significant change in the trend of anaphylaxis rates was seen for children ages three to seventeen, or in children of any age with an already established peanut allergy.
The authors conclude that early peanut introduction guidelines are associated with a reduced risk of new-onset peanut-induced anaphylaxis in young children within a single center in Montreal.
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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