Research Update from ACAAI 2017

At the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI), held Oct. 26-30 in Boston, researchers reported that adult-onset food allergies are more common than previously thought, peanut allergy is among the food allergies in children that have become more common since 2010, and most pediatricians are not following new guidelines for early peanut introduction.

Two late-breaking presentations by researchers at Northwestern University School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago examined food allergy in adults and children. A survey of more than 53,000 households in 2015-2016 measured the prevalence of allergies to peanut, shellfish, tree nut, fin fish, and sesame in adults 18 years or older. Shellfish was the most common allergy in adults (3.69 percent), followed by peanut allergy (2.66 percent). Black, Asian, and Hispanic adults were significantly more likely than whites to have shellfish or peanut allergies. Surprisingly, 45 percent of adults with food allergy reported that at least one of their allergies had developed after age 17.

More than 40,000 children under age 18 were included in the 2015-2016 survey. Among these children, peanut was the most common food allergen (2.42 percent). Childhood peanut, tree nut, shellfish, fin fish, and sesame allergies all appear to be on the rise. The prevalence of peanut allergy has increased by 21 percent since 2010, and tree nut allergy prevalence is up 18 percent. Black children were roughly twice as likely as white children to develop peanut allergy and were also at greater risk for tree nut, fin fish and shellfish allergy. More than half of children with one of those four allergies reported at least one severe allergic reaction.

Unfortunately, best practices to prevent childhood peanut allergy have not been widely adopted. Of 79 pediatricians responding to a survey about peanut introduction, only 11 percent reported that they strictly follow the National Institute of Allergy and Infectious Disease’s 2017 guidelines. These guidelines are based on the LEAP study, which found that babies with egg allergy or eczema are 80 percent less likely to develop peanut allergy if they start eating peanut foods during infancy. Despite the strength of the LEAP study findings, less than one quarter of the pediatricians are recommending peanut foods for babies age 4-6 months who are at high-risk for peanut allergy. Slightly more than half recommend that high-risk babies be tested for peanut allergy before peanut introduction.

FARE Patient Registry Director Luis Garcia spoke to more than 500 allergists who arrived early for the special Thursday session, "New Horizons in Food Allergy?" His talk introduced the FARE Patient Registry, which has enrolled 2,500 patients since its launch in May 2017. He also shared highlights from FARE’s research program, including the FARE Clinical Network that coordinates research and clinical care practices at top institutions, the FARE Investigator Awards that engage innovative scientists in food allergy research, and the Outcomes Research Advisory Board through which food allergy patient representatives work to inform the research agenda. As exhibitors at the conference, FARE staff collected orders for Your Food Allergy Field Guide ­ a free resource that many allergists distribute to patients at their first visit ­ and represented FARE’s ongoing initiatives in food allergy research, education, awareness and advocacy.

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