Debra de Silva1, Susanne Halken2, Chris Singh1, Antonella Muraro3, Elizabeth Angier4, Stefania Arasi5, Hasan Arshad6,7,8, Kirsten Beyer9, Robert Boyle10, Philippe Eigenmann11, Kate Grimshaw7,12, Arne Hoest2, Carla Jones13, Gideon Lack14, Hania Szajewska15, George du Toit14, Carina Venter16, Valérie Verhasselt17, Graham Roberts6,8,18. 1. The Evidence Centre Ltd, London, UK. 2. Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark. 3. Department of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua General University Hospital, Padua, Italy. 4. Faculty of Medicine, Primary Care and Public Health, University of Southampton, Southampton, UK. 5. Pediatric Allergology Unit, Bambino Gesu Hospital, Rome, Italy. 6. NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK. 7. Faculty of Medicine, Clinical and Experimental Sciences, University of Southampton, Southampton, UK. 8. The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK. 9. Department of Pediatric Pneumology and Immunology, Charite Universitatsmedizin Berlin, Berlin, Germany. 10. Imperial College London, London, UK. 11. Pediatric Allergy Unit, Department of Pediatrics, University Hospitals of Geneva, Geneva, Switzerland. 12. Department of Dietetics, Salford Royal NHS Foundation Trust, Salford, UK. 13. Allergy UK, Sidcup, UK. 14. Department of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, Guy's and St Thomas', NHS Foundation Trust, London, UK. 15. Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland. 16. Section of Allergy and Immunology, University of Colorado and Children's Hospital Colorado, Aurora, CO, USA. 17. University of Western Australia, Perth, Australia. 18. Faculty of Medicine, Clinical and Experimental Sciences and Human Development in Health, University of Southampton, Southampton, UK.
Abstract
BACKGROUND: More than 17 million people across Europe have allergies to food and the burden of food allergies is increasing. In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published guidelines for preventing food allergy. Important research has been published since then and it is essential to ensure the guidelines reflect the latest evidence. A systematic review will be undertaken to help prepare new guidelines due to be published in 2020. METHODS: Eleven bibliographic databases will be searched from inception to 31 October 2019 for randomized controlled trials about any intervention designed to prevent the development of new cases of immediate-type/IgE-mediated food allergy in infants, children and adults. There are few randomized controlled trials about the impact of breastfeeding on food allergy so prospective cohort studies about breastfeeding with at least 1000 participants at general risk or 200 at high risk of food allergy will also be eligible. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to assess the certainty of the evidence and tabulate summary data. The risk of bias in individual trials will be assessed using the Cochrane risk of bias tool. All data extraction and quality appraisal will be undertaken independently by two reviewers in partnership with a taskforce of EAACI members. CONCLUSIONS: Preventing food allergy has the potential to improve personal well-being and reduce societal healthcare costs. It is important that forthcoming European guidelines take the latest research into account. Past reviews have tended to focus on single interventions or combined food allergy with other outcomes, making it difficult to draw robust conclusions about potential impacts for policy and practice.
BACKGROUND: More than 17 million people across Europe have allergies to food and the burden of food allergies is increasing. In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published guidelines for preventing food allergy. Important research has been published since then and it is essential to ensure the guidelines reflect the latest evidence. A systematic review will be undertaken to help prepare new guidelines due to be published in 2020. METHODS: Eleven bibliographic databases will be searched from inception to 31 October 2019 for randomized controlled trials about any intervention designed to prevent the development of new cases of immediate-type/IgE-mediated food allergy in infants, children and adults. There are few randomized controlled trials about the impact of breastfeeding on food allergy so prospective cohort studies about breastfeeding with at least 1000 participants at general risk or 200 at high risk of food allergy will also be eligible. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to assess the certainty of the evidence and tabulate summary data. The risk of bias in individual trials will be assessed using the Cochrane risk of bias tool. All data extraction and quality appraisal will be undertaken independently by two reviewers in partnership with a taskforce of EAACI members. CONCLUSIONS: Preventing food allergy has the potential to improve personal well-being and reduce societal healthcare costs. It is important that forthcoming European guidelines take the latest research into account. Past reviews have tended to focus on single interventions or combined food allergy with other outcomes, making it difficult to draw robust conclusions about potential impacts for policy and practice.
Authors: Carina Venter; Carlo Agostoni; S Hasan Arshad; Miriam Ben-Abdallah; George Du Toit; David M Fleischer; Matthew Greenhawt; Deborah H Glueck; Marion Groetch; Nonhlanhla Lunjani; Kate Maslin; Alexander Maiorella; Rosan Meyer; Muraro Antonella; Merryn J Netting; Bright Ibeabughichi Nwaru; Debra J Palmer; Micheala P Palumbo; Graham Roberts; Caroline Roduit; Pete Smith; Eva Untersmayr; Lauren A Vanderlinden; Liam O'Mahony Journal: Pediatr Allergy Immunol Date: 2020-08-06 Impact factor: 5.464