Awareness of oral immunotherapy for food allergy remains low among patients, caregivers

Awareness of oral immunotherapy for food allergy appeared low among those affected and pediatric caregivers, according to survey results published in The Journal of Allergy and Clinical Immunology: In Practice.

Data included in the study noted that food allergy affects approximately 8% of children and 10% of adults in the U.S., and the current recommendation for food allergy management involves strict avoidance of the food that leads to a reaction along with ready access to epinephrine.

“This poses a great challenge for patients and families as it can impair quality of life, impose financial burdens and potentially result in life-threatening anaphylaxis following accidental ingestion,” Christopher M. Warren, PhD, assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine and director of population health research at Center for Food Allergy and Asthma Research, and colleagues wrote.

Warren and colleagues wrote that although advances in oral immunotherapy (OIT) for food allergy are growing, more data are needed on the current awareness, understanding and experiences regarding OIT among patients.

To address this, the researchers provided a survey to a nationally representative sample of U.S. adults with food allergy or caregivers of children with food allergy. They received 781 responses from all 50 states, with more than half from adults with food allergy and 17% of the sample providing responses for children aged younger than 13 years. Demographics of survey participants were consistent with Current Population Survey national data.

Results showed that 43% of respondents were totally unfamiliar with OIT, 29% had heard of OIT but didn’t know what it was and 22% had familiarity with OIT but no one in the household planned to start such therapy. Four percent of respondents reported a household member planned to start or had already received OIT.

Of those familiar with OIT, 54% expected the treatment outcome to be protection against accidental exposure, a belief shared by 34% of those unfamiliar with OIT after reading a brief description. In contrast, 35% of those unfamiliar with OIT believed the outcome would be a cure for their food allergy.

Respondents familiar with OIT also reported that scientific studies on OIT (32%), information about its potential risks (32%) and benefits (26%), how it works (28%) and how much it would cost (23%) would be types of information that would provide confidence in making an informed treatment decision.

However, 26% reported that none of the aforementioned information would potentially change their level of interest in OIT.

After respondents with no familiarity of OIT were read a brief description and then asked their attitude about OIT, they reported feeling neutral (42%), somewhat interested (28%) and very interested (10%).

Further, 16% reported no interest and 5% reported opposition to OIT. This stance was often based on a preference for allergen avoidance (43%), uncertainty about its potential benefits (35%) and uncertainty about accepting the risks of treatment (30%).

Multiple logistic regression analysis showed that households with a yearly income of more than $100,000 or with a college degree were more likely to report any level of OIT awareness compared with lower-income households (OR = 2; 95% CI, 1.2-3.4) and those without a college degree (OR = 1.9; 95% CI, 1.2-3).

The study may be limited by the fact these were patient/proxy self-reports, and the possibility that some patients had a non-IgE-mediated food allergy that would be ineligible for OIT.

“As the therapeutic landscape expands, providers should work to ensure that all eligible patients, regardless of their background, have an equitable opportunity to benefit from the latest immunotherapeutic advances,” Warren and colleagues wrote.