TY - JOUR
T1 - Managing food allergy
T2 - GA2LEN guideline 2022
AU - GALEN Food Allergy Guideline Group
AU - Muraro, Antonella
AU - de Silva, Debra
AU - Halken, Susanne
AU - Worm, Margitta
AU - Khaleva, Ekaterina
AU - Arasi, Stefania
AU - Dunn-Galvin, Audrey
AU - Nwaru, Bright I.
AU - De Jong, Nicolette W.
AU - Rodríguez Del Río, Pablo
AU - Turner, Paul J.
AU - Smith, Pete
AU - Begin, Philippe
AU - Angier, Elizabeth
AU - Arshad, Hasan
AU - Ballmer-Weber, Barbara
AU - Beyer, Kirsten
AU - Bindslev-Jensen, Carsten
AU - Cianferoni, Antonella
AU - Demoulin, Céline
AU - Deschildre, Antoine
AU - Ebisawa, Motohiro
AU - Fernandez-Rivas, Maria Montserrat
AU - Fiocchi, Alessandro
AU - Flokstra-de Blok, Bertine
AU - Gerdts, Jennifer
AU - Gradman, Josefine
AU - Grimshaw, Kate
AU - Jones, Carla
AU - Lau, Susanne
AU - Loh, Richard
AU - Alvaro Lozano, Montserrat
AU - Makela, Mika
AU - Marchisotto, Mary Jane
AU - Meyer, Rosan
AU - Mills, Clare
AU - Nilsson, Caroline
AU - Nowak-Wegrzyn, Anna
AU - Nurmatov, Ulugbek
AU - Pajno, Giovanni
AU - Podestà, Marcia
AU - Poulsen, Lars K.
AU - Sampson, Hugh A.
AU - Sanchez, Angel
AU - Schnadt, Sabine
AU - Szajewska, Hania
AU - Van Ree, Ronald
AU - Venter, Carina
AU - Vlieg-Boerstra, Berber
AU - Warner, Amena
AU - Wong, Gary
AU - Wood, Robert
AU - Zuberbier, Torsten
AU - Roberts, Graham
N1 - Funding Information:
Philippe Begin: personal fees: ALK, Aralez, Astra-Zeneca, Bausch health, DBV, Food Allergy Canada, Novartis, Pfizer, Sanofi, grants: Canadian Allergy and Immunology Foundation, Canadian Institutes of Health Research, DBV, Fonds de Recherches du Québec, Ministère de l’économie et de l'innovation du Québec, Novartis, Ontario Research Funds, Regeneron, Sanofi.
Funding Information:
Hasan Arshad: grant: Food Standard Agency, Natasha Allergy Research Foundation.
Funding Information:
Bertine Flokstra: employment: General Practitioners Research Institute (GPRI); GPRI has conducted investigator- and sponsor-initiated research funded by non-commercial organizations, academic institutes, and pharmaceutical companies (including AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Mundipharma, Novartis, and Teva).
Funding Information:
Paul J Turner: personal fees: from Aimmune Therapeutics, DBV Technologies, Allergenis, UK Food Standards Agency; grants: National Institute for Health Research (NIHR)/Imperial Biomedical Research Centre, UK Medical Research Council, UK Food Standards Agency, End Allergies Together, Jon Moulton Charity Trust.
Funding Information:
Antoine Deschildre: personal fees from Novartis, ALK, GSK, Sanofi, Aimmune Therapeutics, DBV Technologies, Nestlé Health Science, Boehringer Ingelheim, Stallergenes Greer, DBV Technologies, Nutricia. Grant from Fondation du Souffle, Conseil Régional Hauts-de-France Research Program 2014–2018.
Funding Information:
Elizabeth Angier: grant: Natasha Allergy Research Foundation; expert testimony UK Medicines and Healthcare Regulatory Authority; leadership BSACI, EAACI, WONCA.
Publisher Copyright:
© 2022
PY - 2022/9
Y1 - 2022/9
N2 - Food allergy affects approximately 2–4% of children and adults. This guideline provides recommendations for managing food allergy from the Global Allergy and Asthma European Network (GA2LEN). 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.
AB - Food allergy affects approximately 2–4% of children and adults. This guideline provides recommendations for managing food allergy from the Global Allergy and Asthma European Network (GA2LEN). 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.
KW - Adolescent
KW - Adults
KW - Children
KW - Food allergy
KW - Food hypersensitivity
U2 - 10.1016/j.waojou.2022.100687
DO - 10.1016/j.waojou.2022.100687
M3 - Review article
AN - SCOPUS:85137052328
SN - 1939-4551
VL - 15
JO - World Allergy Organization Journal
JF - World Allergy Organization Journal
IS - 9
M1 - 100687
ER -