New guidelines for oral immunotherapy for food allergies

New international guidelines standardize how physicians should prepare families who plan to administer oral immunotherapy to their child with allergies. Since oral immunotherapy involves building a child’s tolerance to food allergies by gradually giving small portions of the allergen, it is usually done at home. This puts a great responsibility on families and caregivers to properly understand and supervise the process. Prior to these guidelines, physicians had little guidance on how to effectively prepare patients and families. "These families must provide the therapy every single day. That’s why these guidelines are so important. Safety can be optimized to make sure that they understand what they’re taking on, while ensuring that they are aware of the kinds of side-effects that can be dangerous," said Dr. Douglas Mack in a press release. Dr. Mack is the lead author of the paper and assistant clinical professor with McMaster University’s department of pediatrics.Recommendations include:Following a standardized education process for patients and families that allows for full consentMaking sure patient and family goals are clearly understood by all involvedEstablishing adequate supervision for dosing before the start of treatmentIdentifying risk factors for a poor outcome that would make physicians not recommend the procedure, such as uncontrolled asthma, unwillingness to use epinephrine and uncontrolled psychological concerns.The guidelines also provide a template consent form physicians can use to make sure patients and their families fully understand the risks, benefits and alternatives to oral immunotherapy. "If families are not prepared for oral immunotherapy, they’re going to fail or it’s going to become unsafe," Dr. Mack said."If they decide they want to do it after following these guidelines, they’re prepared for what they’re getting into. They understand the risks and most importantly, it makes it safer because they can anticipate the challenges. This protocol sets the standard moving forward."The recommendations were developed by 36 oral immunotherapy experts from around the world. They identified 250 statements about prescribing oral immunotherapy and 71 statements about crafting a consent form that reached consensus.Oral immunotherapy is indicated for patients up to 17 years old, the panel agreed. No consensus was reached about patients over 18 years old. The panel reached a consensus that having multiple food allergies is an indication for the therapy.The paper was published in the Journal of Allergy and Clinical Immunology.Read: Updated recommendations for use of pneumococcal vaccines in children

New guidelines for oral immunotherapy for food allergies

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