Management of IgE‐mediated food allergy in the 21st century

• Published in: Clinical and experimental allergy Vol. 53; no. 1; pp. 25 - 38
• Main Authors: Cafarotti, Arianna, Giovannini, Mattia, Begìn, Philippe, Brough, Helen A., Arasi, Stefania
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.01.2023; John Wiley and Sons Inc
• Subjects: 21st century; Allergens; Anaphylaxis; Anaphylaxis - diagnosis; Anaphylaxis - etiology; Anaphylaxis - prevention & control; Decision making; Epinephrine; Food; Food allergies; Food Hypersensitivity - drug therapy; Food Hypersensitivity - therapy; Humans; Immunoglobulin E; Immunotherapy; Review; Standardization
• ISSN: 0954-7894; 1365-2222; 1365-2222
• DOI: 10.1111/cea.14241

The 21st century has seen the propulsion of research in the field of food allergy, which has driven real changes in the clinical approach. Allergen immunotherapy has been recommended for the active management of food allergy. Data have shown promising additional methods of treatment, including biologics. Efforts have been devoted to the risk stratification of food allergy and the standardization of the assessment of food‐allergic severity. Alternative routes of administration of epinephrine are under investigation to minimize any mechanical issue and the fear of injections. Evidence‐based guidelines have been published by the main international societies in the field of anaphylaxis and food allergy management and new updates are in preparation. In the coming years, treatment options that are currently in pre‐clinical or early clinical evaluation will hopefully lead to safe and effective disease‐modifying therapies for food allergy in clinical practice. The identification of reliable biomarkers and the standardization of definitions and measurement approaches, alongside a shared decision‐making with patients and families, will be key for the development of personalized care and to help minimize the substantial burden of food allergy. The 21st century has seen the propulsion of research in the field of food allergy, which has driven real changes in the clinical approach: (a) Oral immunotherapy is the first treatment recommended for the active management of food allergy; (b) Increasing data support biologics as promising therapeutic options as monotherapy or combined with immunotherapy; (c) Proper risk‐stratification and severity assessment are pivotal for a targeted and cost‐effective approach.