Year: 2022
Type: review
Abstract: LEN). A multidisciplinary international Task Force developed the guideline using the Appraisal of Guidelines for Research and Evaluation (AGREE) II framework and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. We reviewed the latest available evidence as of April 2021 (161 studies) and created recommendations by balancing benefits, harms, feasibility, and patient and clinician experiences. We suggest that people diagnosed with food allergy avoid triggering allergens (low certainty evidence). We suggest that infants with cow's milk allergy who need a breastmilk alternative use either hypoallergenic extensively hydrolyzed cow's milk formula or an amino acid-based formula (moderate certainty). For selected children with peanut allergy, we recommend oral immunotherapy (high certainty), though epicutaneous immunotherapy might be considered depending on individual preferences and availability (moderate certainty). We suggest considering oral immunotherapy for children with persistent severe hen's egg or cow's milk allergy (moderate certainty). There are significant gaps in evidence about safety and effectiveness of the various strategies. Research is needed to determine the best approaches to education, how to predict the risk of severe reactions, whether immunotherapy is cost-effective and whether biological therapies are effective alone or combined with allergen immunotherapy.
Authors: Antonella Muraro, Debra de Silva, Susanne Halken, Margitta Worm, Ekaterina Khaleva, Stefania Arasi, Audrey Dunn-Galvin, Bright I. Nwaru, Nicolette W. De Jong, Pablo Rodríguez Del Río, Paul J. Turner, Pete Smith, Philippe Begin, Elizabeth Angier, Hasan Arshad, Barbara Ballmer-Weber, Kirsten Beyer, Carsten Bindslev-Jensen, Antonella Cianferoni, Céline Demoulin, Antoine Deschildre, Motohiro Ebisawa, Maria Montserrat Fernandez-Rivas, Alessandro Fiocchi, Bertine Flokstra-de Blok, Jennifer Gerdts, Josefine Gradman, Kate Grimshaw, Carla Jones, Susanne Lau, Richard Loh, Montserrat Alvaro Lozano, Mika Makela, Mary Jane Marchisotto, Rosan Meyer, Clare Mills, Caroline Nilsson, Anna Nowak-Wegrzyn, Ulugbek Nurmatov, Giovanni Pajno, Marcia Podestà, Lars K. Poulsen, Hugh A. Sampson, Angel Sanchez, Sabine Schnadt, Hania Szajewska, Ronald Van Ree, Carina Venter, Berber Vlieg-Boerstra, Amena Warner, Gary Wong, Robert Wood, Torsten Zuberbier, Graham Roberts, Priya Bansal, Roberto Berni–Canani, Katharina Blumchen, Andreas Bonertz, Melisande Bourgoin-Heck, Ozlem Ceylon, Amandine Divaret-Chauveau, David Fleischer, Maximiliano Gomez, Marion Groetch, Domingo Barber Hernandez, Betina Hjorth, Lydia Collins Hussey, André C. Knulst, Agnes Leung, Douglas Mack, Vera Mahler, Francesca Mori, Leyla Namazova-Baranova, Kati Palosuo, Claudio Alberto Salvador Parisi, Antonio Carlos Pastorino, Odilija Rudzeviciene, Maria Said, Piotr Sawiec, Scott Sicherer, Sakura Sato, Svitlana Zubchenko
Institutions: Azienda Ospedale - Università Padova, Odense University Hospital, Charité – Universitätsmedizin Berlin, University of Southampton, Bambino Gesù Children's Hospital, University College Cork, University of Gothenburg, Erasmus MC, Hospital Infantil Universitario Niño Jesús, Imperial College London, Griffith University, Université de Montréal, Kantonsspital St. Gallen, University Hospital Zurich, Children's Hospital of Philadelphia, University of Pennsylvania, Université de Lille, Centre Hospitalier Universitaire de Lille, Hôpital Jeanne de Flandre, National Sagamihara Hospital, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, University Medical Center Groningen, University of Groningen, General Practitioners Research Institute, Food Allergy Canada, Princess Margaret Hospital for Children, Perth Children's Hospital, Helsinki University Hospital, University Hospital Southampton NHS Foundation Trust, University of Manchester, Karolinska Institutet, Stockholm South General Hospital, Sachs' Children and Youth Hospital, Yale University, University of Warmia and Mazury in Olsztyn, Cardiff University, University of Messina, Azienda Ospedaliera Universitaria Policlinico "G. Martino", Copenhagen University Hospital, Icahn School of Medicine at Mount Sinai, Medical University of Warsaw, Amsterdam University Medical Centers, Children's Hospital Colorado, OLVG, Chinese University of Hong Kong, Johns Hopkins University, NIHR Southampton Biomedical Research Centre
Language: English
Subfield: Immunology and Allergy
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,540
Funders: AstraZeneca, Yale University, Teva Pharmaceutical Industries, Children's Hospital Colorado, Johns Hopkins University, University Hospital Southampton NHS Foundation Trust, Aimmune Therapeutics, Amsterdam University Medical Centers, National Institute for Health and Care Research, Cardiff University, Gentofte Hospital, Karolinska Institutet, Warszawski Uniwersytet Medyczny, Uniwersytet Warszawski, Università degli Studi di Messina, Medical Research Council
OpenAlex ID: W4294898352