New Guidelines for Safer Food Allergy Therapy

Researchers, including Dr. Douglas Mack of McMaster University, have developed new guidelines aimed at improving the safety and effectiveness of oral immunotherapy (OIT) for food allergies. These guidelines are designed to provide clinicians with recommendations for better preparing patients and caregivers for OIT, identifying risk factors that may preclude its use, and ensuring adequate supervision during therapy. The guidelines, while not mandatory, offer hope for better outcomes in managing food allergies, which affect nearly 600,000 Canadian children.

Oral immunotherapy, a treatment that introduces food allergens in small, gradually increasing amounts, has been used for decades to help patients build tolerance. However, the lack of standardized education and formal training for caregivers has raised concerns about the safety of administering OIT, especially at home. The new guidelines address these issues by recommending a robust education process for clinicians and caregivers, which could lead to more successful and safer therapy experiences.

Food Allergy Canada’s executive director, Jennifer Gerdts, highlighted the potential benefits of OIT, including improved quality of life and reduced anxiety for patients, even for those who had to stop treatment. She emphasized the need for better access to allergy treatments, urging policymakers to take action to make such therapies more widely available.

The guidelines also suggest ways to determine the likelihood of OIT success by identifying risk factors like uncontrolled asthma or food aversion. Severe reactions requiring epinephrine are also a consideration for discontinuing treatment. Dr. Mack acknowledges the burden on caregivers to monitor children during OIT but believes that proper preparation can lead to more positive results.

While OIT has shown to desensitize about 60 to 80 percent of patients in studies, the American Academy of Allergy Asthma and Immunology notes that it is not yet clear if this desensitization can protect against accidental exposures in the real world. The new guidelines aim to refine the therapy process, potentially offering a more liberating experience for those living with food allergies.