Managing food allergy: GALEN guideline 2022.

Publication

Managing food allergy: GALEN guideline 2022.

Journal Paper/Review - Sep 7, 2022

Muraro Antonella, de Silva Debra, Halken Susanne, Worm Margitta, Khaleva Ekaterina, Arasi Stefania, Dunn-Galvin Audrey, Nwaru Bright I, de Jong Nicolette, Rodríguez Del Río Pablo, Turner Paul J, Smitham Peter J, Bégin Philippe, Angier Elizabeth, Arshad Hasan, Ballmer-Weber Barbara, Beyer Kirsten, Bindslev-Jensen Carsten, Cianferoni Antonella, Demoulin Céline, Deschildre Antoine, Ebisawa Motohiro, Fernandez-Rivas Maria Montserrat, Fiocchi Alessandro, Flokstra-de Blok Bertine, Gerdts Jennifer D, Gradman Josefine, Grimshaw Kate, Jones Carla, Lau Susanne, Loh Richard, Alvaro Montserrat, Mäkelä Mika, Marchisotto Mary Jane, Meyer Rosan, Mills Clare, Nilsson Caroline, Nowak-Wegrzyn Anna, Nurmatov Ulugbek, Pajno Giovanni Battista, Podestà Marcia, Poulsen Lars K, Sampson Hugh A, Sanchez Angel, Schnadt Sabine, Szajewska Hania, Van Ree Ronald, Venter Carina, Vlieg-Boerstra Berber, Warner Amena, Wong Gary W K, Wood Robert, Zuberbier Torsten, Roberts Graham

Citation

Muraro A, de Silva D, Halken S, Worm M, Khaleva E, Arasi S, Dunn-Galvin A, Nwaru B, de Jong N, Rodríguez Del Río P, Turner P, Smitham P, Bégin P, Angier E, Arshad H, Ballmer-Weber B, Beyer K, Bindslev-Jensen C, Cianferoni A, Demoulin C, Deschildre A, Ebisawa M, Fernandez-Rivas M, Fiocchi A, Flokstra-de Blok B, Gerdts J, Gradman J, Grimshaw K, Jones C, Lau S, Loh R, Alvaro M, Mäkelä M, Marchisotto M, Meyer R, Mills C, Nilsson C, Nowak-Wegrzyn A, Nurmatov U, Pajno G, Podestà M, Poulsen L, Sampson H, Sanchez A, Schnadt S, Szajewska H, Van Ree R, Venter C, Vlieg-Boerstra B, Warner A, Wong G, Wood R, Zuberbier T, Roberts G. Managing food allergy: GALEN guideline 2022. World Allergy Organ J 2022; 15:100687.

Type

Journal Paper/Review (English)

Journal

World Allergy Organ J 2022; 15

Publication Date

Sep 7, 2022

Issn Print

1939-4551

Pages

100687

Brief description/objective

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 (GALEN). 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.