Food immunotherapy practice: Nation differences across Europe, the FIND project. Issue 3 (3rd August 2021)

• Record Type: Journal Article
• Authors: Rodríguez del Río, Pablo; Alvarez‐Perea, Alberto; Blumchen, Katharina; Caimmi, Davide; Caubet, Jean Christoph; Konstantinopoulos, Anastasios Panagiotis; Riggioni, Carmen; Fassio, Filippo; Karakoc‐Aydiner, Elif; Le, Thuy May; Patel, Nandinee; Savolainen, Johannes; Vazquez‐Ortiz, Marta; Alvaro Lozano, Montserrat
• Is Part Of: Allergy. Volume 77:Issue 3(2022)
• Page Start: 920
• Page End: 932
• Publication Date: 2021-08-03
• Subjects: allergy -- egg -- food immunotherapy -- milk -- peanut; Allergy -- Periodicals; 616.97
• DOI: 10.1111/all.15016
• Languages: English
• ISSNs: 0105-4538

Abstract

Abstract: Background: Food allergen immunotherapy (FA‐AIT) practice is known to vary globally. This project aims to identify and characterize European centres performing FA‐AIT. Methods: An EAACI task force conducted an online survey to gather relevant information regarding FA‐AIT practice and setting‐specific resources after reviewing the published literature and congress abstracts throughout Europe. Results: We identified 102 FA‐AIT centres in 18 countries; only Spain ( n = 39) and France ( n = 16) had ≥10 such centres. Overall, most facilities were hospital‐based (77.5%), publicly funded (80.4%) and delivered FA‐AIT as routine clinical care (80.4%). On average, departments had 3 allergists/paediatric allergists and 2 nurses. Surveyed centres had provided FA‐AIT for a median of 9 years [1–24] to a median of 105 [5–2415] patients. The estimated total number of treated patients was 24875, of whom 41.3% received AIT for milk, 34.2% egg, 12.8% peanut and 11.7% other foods. Anaphylaxis to AIT doses requiring over 4–6 h of observation was reported by 70.6% of centres, ICU admissions by 10.8% and eosinophilic esophagitis by 45.1%. Quality of life and sustained unresponsiveness were evaluated in 20.6% and 54.9% of centres, respectively. The main contraindications for food AIT were severe asthma (57%‐63%), eosinophilic esophagitis (56%‐48%) and age below 5 years (47%‐41%). Conclusions: In Europe, FA‐AIT is provided mostly in clinical practice. Significant variation is seen in the number of centres per country, facility characteristics and inclusion/exclusion criteria, and in certain aspects of protocols. Potential inequality in access to AIT has been identified as well as the need for education and guidance for treatment standardization. Abstract : Food AIT in Europe is mostly given in clinical practice. There is a significant heterogeneity throughout countries in treatment availability and administration patterns. There is a significant gap between a growing treatment demand and clinical food‐AIT providers able to deliver the treatment that represents a challenge for all stakeholders. Abbreviations: AIT, allergen immunotherapy; CH, Switzerland; n, number; NL, Netherlands; UK, United Kingdom