Therapy target
Freedom from symptoms
Therapy recommendations
- There is no drug therapy for food allergy!
- In the presence of anaphylactic shock – see under “Shock/Medicinal Therapy“.
- If there is a reasonable suspicion of a food allergy (see below laboratory diagnostics), a so-called elimination diet is carried out for a maximum of 2 weeks. This involves a complete omission of all food components that may be related to the allergy. If there is no improvement in the condition, it is probably not a food allergy. However, if there is an improvement in the patient’s condition, all the previously omitted foods are reintroduced one by one to find out the allergen. This is called provocation.Without the oral immunotherapy.Note: In 2020, the U.S. Food and Drug Administration (FDA) approved Peanut (Arachis hypogaea) Allergen Powder-dnfp oral immunotherapy for children between the ages of four and 17.
- Oral immunotherapy for food allergy mediated by specific immunoglobulins E (IgE) antibodies is being discussed or has now been approved (see “Further guidance” below).
- See also under “Further therapy“.
Further notes
- Oral immunotherapy
- Peanut Allergy: Results of a phase III study demonstrated that oral immunotherapy (OIT) in children and adolescents (participants: 551 patients aged 4 to 55 years; 496 were younger than 18 years) with peanut can protect them from severe reactions after accidental exposure: In the group of 4- to 17-year-old patients (250 of 372 patients), they were able to tolerate a dose of 600 mg of peanut protein (equivalent to at least 2 peanuts) after completion of therapy. Note: OIT with peanut increased the risk and frequency of anaphylaxis by about threefold compared with no therapy (22, 2 vs. 7.1 percent); OIT children were about twice as likely to require epinephrine as emergency medication compared with children in the control group without the oral immunotherapy.
- Wheat allergy: In a first small study in which wheat allergy was previously confirmed by double-blind placebo-controlled oral food challenge, specific immunotherapy was shown to be effective: In the group that started the high-dose oral ,specific immunotherapy (1,445 mg wheat protein), 12 of 21 patients (57.1%) achieved the goal of tolerating 7,443 mg wheat protein. How long the efficacy of specific immunotherapy lasts is still unclear.
