INCREASED INCIDENCE AND PREVALENCE OF PEANUT ALLERGY IN CHILDREN AND ADOLESCENTS IN THE UNITED STATES

• Published in: Annals of allergy, asthma, & immunology Vol. 121; no. 5; p. S13
• Main Authors: Lieberman, J., Sublett, J., Ali, Y., Haselkorn, T., Damle, V., Chidambaram, A., Rosen, K., Mahr, T.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.11.2018
• ISSN: 1081-1206; 1534-4436
• DOI: 10.1016/j.anai.2018.09.039

Peanut allergy (PA) is associated with high rates of severe reactions and impaired quality of life, yet epidemiologic data are limited. Utilizing a real-world, nationally representative cohort of children/adolescents, we examined incidence and prevalence of PA. Longitudinal data between January 2011-December 2017 from a geographically and payor-type representative US healthcare claims database were utilized. Patients aged 4-17 years with PA were identified using diagnostic codes and/or services indicating PA-associated severe reactions/anaphylaxis. Prevalence estimates were projected, accounting for dataset capture rates by healthcare setting (40% outpatient clinic, 25% hospital), 30% under-coding, and patient under-presenting (8-15% based on patient age). Estimated annual incidence was defined as PA births as a proportion of all 1-year-old babies. Incidence was computed from prevalence estimates, aging patients back to age 1, adjusting for spontaneous outgrowth of PA (27% by age 12). Estimated prevalence of PA was 1.25 million (2.2%) in 2017. Of these patients, ∼500K were diagnosed by allergists; ∼370K diagnosed by pediatricians and managed by allergists; and ∼380K diagnosed and managed by outside of allergists. Common comorbidities included eczema (63%) and asthma (61%); 35% of PA patients had ≥1 additional food allergy. Annual incidence of PA in 1-year-olds increased, from an estimated 1.7% to 5.2% between 2001-2017 (Figure). Approximately 2.2% of children/adolescents in the US have PA. Annual incidence has increased since 2001; current annual incidence in 1-year-olds is ∼5%.  Findings indicate an increase in both incidence and prevalence of PA, suggesting the impact of PA may be greater than previously reported. Figure. Incidence of PA Among 4–17-Year-Olds in the United States Between 2001–2017