Relevant outcomes for patients with food allergies undergoing immunotherapy treatment
Published online May 7, 2025
Treatment of food allergy with immunotherapy is rapidly increasing, supported by evidence from clinical trials and real-life use. Efficacy outcomes have been mostly researcher-oriented, but little is known about the perspectives of patients. Food allergy quality of life (FAQoL) has been the most common patient reported outcome (PRO) evaluated. Currently, we do not know which outcomes are important for patients and their families receiving food immunotherapy or how these outcomes may vary according to a patient´s clinical or demographic profile.
Rodríguez del Río et al. carried out a prospective international study published in The Journal of Allergy and Clinical Immunology: In Practice where parents of children undergoing food allergen immunotherapy were surveyed to collect their views on potential efficacy outcomes of the treatment. The survey posed questions to parents/caregivers regarding the patients’ socioeconomic and allergy profiles, characteristics of food allergen immunotherapy and its outcomes, FAQoL, and a list of 19 proposed PROs. An innovative cluster analysis grouping the preferences for the 19 outcomes evaluated was carried out, and the phenotype of the groups showing different characteristics was analyzed.
A total of 857 participants from different countries of North America and Europe completed the questionnaire, where 41.5%, 39.7%, and 18.8% were on milk, peanut, or egg allergen immunotherapy, respectively. For parents, the most relevant efficacy outcome of food allergen immunotherapy was the potential to mitigate the risk of death from accidental ingestions. This was followed by the treatment facilitating the patient enjoying life more fully. Interestingly, the relevance of these 19 outcomes differed significantly due to several factors. The most significant factors in the clusters’ configuration were food on treatment, the area of origin of the patient, and their FAQoL level of impairment. Briefly, five different groups were identified with their main topic being: Cluster 1, high expectations from the treatment; Cluster 2, aiming to obtain more than mere protection against allergen exposures; Cluster 3, high relevance to improve patient and caregiver’s social functioning; Cluster 4, focused on improvement of patient´s outcomes; and Cluster 5, that surprisingly showed an overall low level of motivation.
The authors concluded that the novel information on patient reported outcomes from this analysis demonstrates the complexity and personalization involved in food immunotherapy and can inform future research to improve patient perceived value of these treatments.
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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