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GRADE-ing the benefit/risk equation in food immunotherapy

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Title: GRADE-ing the benefit/risk equation in food immunotherapy
Authors: Duca, B
Patel, N
Turner, P
Item Type: Journal Article
Abstract: Purpose of Review We reviewed the existing evidence base to desensitisation for food allergy, applying the Grading of Recommendations, Assessment, Development and Evaluation approach to discuss whether desensitisation is likely to become part of routine treatment for patients with food allergy. Recent Findings Desensitisation for food allergy to peanut, egg and cow’s milk is efficacious, but whether such interventions are cost-effective is less clear, due to the issues over a sustained desensitisation effect and the increase in allergic reactions occurring in patients on treatment. Few studies have assessed the change in health-related quality of life associated with treatment, and most have not considered discordance between parent-reported changes in health-related quality of life (HRQL) outcomes compared to those of the patients themselves; none to date have controlled for the improvement in HRQL occurring after initial challenge which will confound outcomes. Summary The lack of longer-term safety and cost-effectiveness data, as well as an absence of current consensus in the reporting of patient-relevant outcomes, must be addressed in order to be able to recommend the introduction of desensitisation as a routine treatment in healthcare systems.
Issue Date: 25-Apr-2019
Date of Acceptance: 15-Mar-2019
URI: http://hdl.handle.net/10044/1/69513
DOI: https://dx.doi.org/10.1007/s11882-019-0862-6
ISSN: 1529-7322
Publisher: Springer (part of Springer Nature)
Journal / Book Title: Current Allergy and Asthma Reports
Volume: 19
Issue: 6
Copyright Statement: © 2019 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http:// creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Sponsor/Funder: Medical Research Council (MRC)
J P Moulton Charitable Foundation
Funder's Grant Number: MR/K010468/1
n/a
Keywords: Desensitisation
Food allergy
Oral immunotherapy
Outcomes
Safety
Allergy
Publication Status: Published
Article Number: 30
Online Publication Date: 2019-04-25
Appears in Collections:Department of Medicine (up to 2019)