TY - JOUR
T1 - Oral Food Challenge for FPIES in Practice—A Survey
T2 - Report from the Work Group on FPIES Within the Adverse Reactions to Foods Committee, FAED IS, AAAAI
AU - Nicolaides, Rory
AU - Bird, J. Andrew
AU - Cianferoni, Antonella
AU - Brown-Whitehorn, Terri
AU - Nowak-Wegrzyn, Anna
N1 - Funding Information:
Conflicts of interest: J. Andrew Bird reports grant support for contracted research from National Institutes of Health / National Institute of Allergy and Infectious Disease , Genentech , Food Allergy Research and Education (FARE), Aimmune Therapeutics , DBV Technologies , and Astellas ; personal fees from Pharm-Olam International Ltd for DSMB service; consulting compensation from Pfizer Pharmaceuticals, Prota Therapeutics, Allergy Therapeutics, Ltd, AllerGenis, Novartis, Before Brands, FARE, Aimmune Therapeutics, and DBV Technologies outside the submitted work; speaker’s fees from Aimmune Therapeutics and DBV Technologies outside the submitted work. He is a member of the medical advisory board of the International FPIES Association (uncompensated). A. Nowak-Wegrzyn reports royalty payments from UpToDate; personal fees from the American College of Allergy, Asthma and Immunology as Deputy Editor of the Annals of Allergy, Asthma, and Immunology; and consulting fees from Nestle, Nutricia, Novartis, and Aimmune outside of the submitted work. She serves as the Chair of the medical advisory board for the International FPIES Association (uncompensated). The rest of the authors declare that they have no relevant conflicts of interest.
Funding Information:
Conflicts of interest: J. Andrew Bird reports grant support for contracted research from National Institutes of Health/National Institute of Allergy and Infectious Disease, Genentech, Food Allergy Research and Education (FARE), Aimmune Therapeutics, DBV Technologies, and Astellas; personal fees from Pharm-Olam International Ltd for DSMB service; consulting compensation from Pfizer Pharmaceuticals, Prota Therapeutics, Allergy Therapeutics, Ltd, AllerGenis, Novartis, Before Brands, FARE, Aimmune Therapeutics, and DBV Technologies outside the submitted work; speaker's fees from Aimmune Therapeutics and DBV Technologies outside the submitted work. He is a member of the medical advisory board of the International FPIES Association (uncompensated). A. Nowak-Wegrzyn reports royalty payments from UpToDate; personal fees from the American College of Allergy, Asthma and Immunology as Deputy Editor of the Annals of Allergy, Asthma, and Immunology; and consulting fees from Nestle, Nutricia, Novartis, and Aimmune outside of the submitted work. She serves as the Chair of the medical advisory board for the International FPIES Association (uncompensated). The rest of the authors declare that they have no relevant conflicts of interest.
Publisher Copyright:
© 2021 American Academy of Allergy, Asthma & Immunology
PY - 2021/10
Y1 - 2021/10
N2 - Background: Food protein–induced enterocolitis syndrome (FPIES) is a non–IgE-mediated food allergy diagnosed via history and/or an oral food challenge (OFC). Objective: To determine allergists’ approach to FPIES OFCs. Methods: A web-based survey was e-mailed to 1100 randomly selected American Academy of Allergy, Asthma and Immunology members. Results: A total of 132 individuals responded (12% response rate). A total of 95.5% (n = 105) of respondents perform OFCs in their practice, but only 58.7% (n = 71) perform FPIES OFCs. The median number of FPIES OFCs in children was reported as 3 per year (range, 0-76); all but 1 respondent (2.5%) had not performed any FPIES OFCs in adults. The most common FPIES OFC foods were cow's milk, rice, lightly cooked egg, oat, soy, baked milk, and baked egg. The decision to offer FPIES OFCs was based on the severity of past reactions, the patient and family's desire, and the patient's age. FPIES OFCs were most commonly performed in an outpatient setting, with placement of peripheral intravenous access depending on the severity of past reactions and with a serving appropriate for age divided into 3 equal portions administered over 30 minutes. There was significant variability in the approach to conducting FPIES OFCs. Most respondents (87.4%, n = 127) indicated that specific guidelines for performing FPIES OFCs would be helpful. Conclusions: Our study highlights the discordance in allergists’ practices performing OFCs for IgE-mediated food allergy compared with FPIES. The lack of universal agreement on the optimal way to perform OFCs in FPIES demonstrates the need for future studies to develop a standardized protocol for FPIES OFCs.
AB - Background: Food protein–induced enterocolitis syndrome (FPIES) is a non–IgE-mediated food allergy diagnosed via history and/or an oral food challenge (OFC). Objective: To determine allergists’ approach to FPIES OFCs. Methods: A web-based survey was e-mailed to 1100 randomly selected American Academy of Allergy, Asthma and Immunology members. Results: A total of 132 individuals responded (12% response rate). A total of 95.5% (n = 105) of respondents perform OFCs in their practice, but only 58.7% (n = 71) perform FPIES OFCs. The median number of FPIES OFCs in children was reported as 3 per year (range, 0-76); all but 1 respondent (2.5%) had not performed any FPIES OFCs in adults. The most common FPIES OFC foods were cow's milk, rice, lightly cooked egg, oat, soy, baked milk, and baked egg. The decision to offer FPIES OFCs was based on the severity of past reactions, the patient and family's desire, and the patient's age. FPIES OFCs were most commonly performed in an outpatient setting, with placement of peripheral intravenous access depending on the severity of past reactions and with a serving appropriate for age divided into 3 equal portions administered over 30 minutes. There was significant variability in the approach to conducting FPIES OFCs. Most respondents (87.4%, n = 127) indicated that specific guidelines for performing FPIES OFCs would be helpful. Conclusions: Our study highlights the discordance in allergists’ practices performing OFCs for IgE-mediated food allergy compared with FPIES. The lack of universal agreement on the optimal way to perform OFCs in FPIES demonstrates the need for future studies to develop a standardized protocol for FPIES OFCs.
KW - Diagnosis
KW - FPIES
KW - Food allergy
KW - Food protein–induced enterocolitis syndrome
KW - OFC
KW - Oral food challenge
UR - http://www.scopus.com/inward/record.url?scp=85114294059&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85114294059&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2021.06.061
DO - 10.1016/j.jaip.2021.06.061
M3 - Article
C2 - 34483087
AN - SCOPUS:85114294059
SN - 2213-2198
VL - 9
SP - 3608-3614.e1
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 10
ER -