Clinical low-risk oral food challenges present few risks in practice, with 98% performed without an anaphylactic event and 86% of challenges having no reaction at all, according to a study published in the Annals of Allergy, Asthma & Immunology
“There is a need to determine the safety of open oral food challenges because food allergies affect up to 6 million people, and the health care cost for food allergies is $24 billion annually attributable to annual medical and out-of-pocket cost, lost labor productivity and forgone caregiver labor market activities,” Kwei Akuete, MD, MPH, from the immunology, allergy and rheumatology section at Texas Children’s Hospital and the department of pediatrics at Baylor College of Medicine, and colleagues wrote.
To observe the epidemiology, symptoms and treatment of clinical low-risk oral food challenges (OFC), the researchers conducted an analysis of data regarding OFCs performed in a nonresearch setting between 2008 and 2013. Information was collected through physician survey at five food allergy centers. Akuete and colleagues then used a linear mixed model to determine allergic reaction rates, as well as the association of reaction rates with the year, hospital and demographics.
Of the 6,377 OFCs performed, anaphylaxis occurred in 2% (95% CI, 1%-3%), and allergic reactions occurred at a rate of 14% (95%, CI, 13%-16%). These rates demonstrated consistency throughout the study period (P =.40). The rates of allergic reaction varied from 13% to 33%, with boys experiencing allergic events 16% more than girls (95% CI, 4%-37.5%; P = 0.04).
The foods that most frequently challenged varied by geographic location in 2013. The most challenged food in the Northeast, Midwest and West was peanut, and eggs were the most challenged food in the South.
“Food challenges improve the quality of life for people with food allergies, even if they are positive,” Carla Davis, MD, allergist and member of the American College of Allergy Asthma and Immunology, said in a press release. “When an OFC is delayed, sometimes people unnecessarily cut certain foods out of their diet, and this has been shown to lead to increases in health costs to the patient. A delay risks problems with nutrition, especially for children. It’s important to have an accurate diagnosis of food allergy so an allergist can make a clear recommendation as to what foods you need to keep out of your diet. And if no allergy exists, that clears the way to reintroduce foods you may have thought were off-limits.” – by Katherine Bortz
Disclosure: The researchers report no relevant financial disclosures.