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EAACI guidelines on the management of IgE‐mediated food allergy

Allergy2024Vol. 80(1), pp. 14–36

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Alexandra F. Santos, Carmen Riggioni, Ioana Agache, Cezmi A. Akdiş, Mübeccel Akdiş, Alberto Álvarez‐Perea, Montserrat Álvaro‐Lozano, Barbara Ballmer‐Weber, Simona Barni, Kirsten Beyer, Carsten Bindslev‐Jensen, Helen A. Brough, Betül Büyüktiryaki, Derek K. Chu, Stefano R. Del Giacco, Audrey DunnGalvin, Bernadette Eberlein, Motohiro Ebisawa, Philippe Eigenmann, Thomas Eiwegger, Mary Feeney, Montserrat Fernández‐Rivas, Alessandro Fiocchi, Helen R. Fisher, David M. Fleischer, Mattia Giovannini, Claudia L. Gray, Karin Hoffmann‐Sommergruber, Susanne Halken, Jonathan O’B Hourihane, Christina Jones, Marek Jutel, Edward F. Knol, George Ν. Konstantinou, Gideon Lack, Susanne Lau, Andreina Marques‐Mejias, Mary Jane Marchisotto, Rosan Meyer, Charlotte G. Mørtz, Beatriz Moya, Antonella Muraro, Caroline Nilsson, Lucila Camargo Lopes de Oliveira, Liam O’Mahony, Nikolaos G. Papadopoulos, Kirsten P. Perrett, Rachel L. Peters, Márcia Helena Miranda Cardoso Podestá, Lars K. Poulsen, Graham Roberts, Hugh A. Sampson, Jürgen Schwarze, Peter Smith, Elizabeth Huiwen Tham, Eva Untersmayr, Ronald van Ree, Carina Venter, Brian P. Vickery, Berber Vlieg‐Boerstra, Thomas Werfel, Margitta Worm, George Du Toit, Isabel Skypala

Abstract

This European Academy of Allergy and Clinical Immunology (EAACI) guideline provides recommendations for the management of IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Following the confirmation of IgE-mediated food allergy diagnosis, allergen avoidance and dietary advice (with support of a specialised dietitian, if possible) together with the provision of a written treatment plan, education on the recognition of allergic symptoms and prescription of medication including adrenaline using an auto-injector are essential. Patients with significant anxiety and requirement for coping strategies may benefit from support from a clinical psychologist. As immunomodulatory interventions, omalizumab is suggested for treatment of IgE-mediated food allergy in children from the age of 1 and adults; and oral allergen-specific immunotherapy is recommended for children and adolescents with peanut allergy and suggested for milk and egg allergies (generally after 4 years of age for milk and egg). Sublingual and epicutaneous immunotherapy are suggested for peanut allergy but are not yet available at the point of care. Future research into disease modifying treatments for IgE-mediated food allergy are highly needed, with standardised and patient-focused protocols and outcomes.

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Abstract

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