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Managing food allergy: GA2LEN guideline 2022

Muraro, Antonella, de Silva, Debra, Halken, Susanne, Worm, Margitta, Khaleva, Ekaterina, Arasi, Stefania, Dunn-Galvin, Audrey, Nwaru, Bright I., De Jong, Nicolette W., Rodríguez Del Río, Pablo, Turner, Paul J., Smith, Pete, Begin, Philippe, Angier, Elizabeth, Arshad, Hasan, Ballmer-Weber, Barbara, Beyer, Kirsten, Bindslev-Jensen, Carsten, Cianferoni, Antonella, Demoulin, Céline, Deschildre, Antoine, Ebisawa, Motohiro, Fernandez-Rivas, Maria Montserrat, Fiocchi, Alessandro, Flokstra-de Blok, Bertine, Gerdts, Jennifer, Gradman, Josefine, Grimshaw, Kate, Jones, Carla, Lau, Susanne, Loh, Richard, Alvaro Lozano, Montserrat, Makela, Mika, Marchisotto, Mary Jane, Meyer, Rosan, Mills, Clare, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nurmatov, Ulugbek ORCID:, Pajno, Giovanni, Podestà, Marcia, Poulsen, Lars K., Sampson, Hugh A., Sanchez, Angel, Schnadt, Sabine, Szajewska, Hania, Van Ree, Ronald, Venter, Carina, Vlieg-Boerstra, Berber, Warner, Amena, Wong, Gary, Wood, Robert, Zuberbier, Torsten and Roberts, Graham 2022. Managing food allergy: GA2LEN guideline 2022. World Allergy Organization Journal 15 (9) , 100687. 10.1016/j.waojou.2022.100687

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Food allergy affects approximately 2–4% of children and adults. This guideline provides recommendations for managing food allergy from the Global Allergy and Asthma European Network (GA2LEN). A multidisciplinary international Task Force developed the guideline using the Appraisal of Guidelines for Research and Evaluation (AGREE) II framework and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. We reviewed the latest available evidence as of April 2021 (161 studies) and created recommendations by balancing benefits, harms, feasibility, and patient and clinician experiences. We suggest that people diagnosed with food allergy avoid triggering allergens (low certainty evidence). We suggest that infants with cow's milk allergy who need a breastmilk alternative use either hypoallergenic extensively hydrolyzed cow's milk formula or an amino acid-based formula (moderate certainty). For selected children with peanut allergy, we recommend oral immunotherapy (high certainty), though epicutaneous immunotherapy might be considered depending on individual preferences and availability (moderate certainty). We suggest considering oral immunotherapy for children with persistent severe hen's egg or cow's milk allergy (moderate certainty). There are significant gaps in evidence about safety and effectiveness of the various strategies. Research is needed to determine the best approaches to education, how to predict the risk of severe reactions, whether immunotherapy is cost-effective and whether biological therapies are effective alone or combined with allergen immunotherapy.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Additional Information: License information from Publisher: LICENSE 1: URL:, Start Date: 2022-08-01
Publisher: Elsevier
ISSN: 1939-4551
Date of First Compliant Deposit: 12 September 2022
Date of Acceptance: 1 August 2022
Last Modified: 21 May 2023 18:53

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