November 10, 2023
3 minute read
- 21% of the total cohort outgrew at least one allergy.
- Patients outgrew these allergies by a mean age of 5.31 years.
- The most common allergies that stopped growing were milk and eggs.
ANAHEIM, Calif. — Children with private insurance are more likely to overcome food allergies than those with public insurance, according to a presentation at the annual scientific meeting of the American College of Allergy, Asthma, and Immunology. is said to be high.
“Despite the increasing prevalence of food allergies, some children outgrow food allergies. However, data on the development of clinical tolerance in food allergies are limited.” Arabelle Abelard, MD, MSc; PGY5 Allergy and Immunology Physician Fellow at Rush University Medical Center told Helio.
“For this reason, we wanted to investigate factors that may be associated with overcoming food allergies in children,” she said.
Researchers studied 188 children 12 years of age and younger (62% boys, 51% Black) with physician-diagnosed IgE-mediated food allergies and compared outcomes related to food allergy management and racial/ethnic differences. (FORWARD). Largest prospective study of children with food allergies.
This cohort included 39 (21%) children who outlived at least one food allergy, of which 72 outgrown food allergies. These patients outgrew these allergies by a mean age of 5.31 years (standard deviation). [SD], 3.5). The most frequently increased allergies included milk, egg, tree nuts, soy, and peanuts.
Of the patients who survived these allergies, 9 (12%) had public insurance and 26 (29%) had private insurance. Also, her one patient who did not have insurance did not report any increased allergies.
Four of the 16 patients who did not have insurance information available or entered into the data extraction tool similarly outgrew their allergies. It’s unclear whether these patients have insurance, Abelard said.
“Additional studies are needed to further characterize these patients and refine the analysis,” Abelard said.
Additionally, patients who developed tolerance developed food allergy at a mean age of 3.19 years (SD, 2.7), whereas patients who did not develop tolerance developed allergies at a mean age of 4.3 years (SD, 3.61). The researchers called this a “significant difference” (P = .043).
Conclusion and next steps
Despite these results, Abelard said it’s not clearly understood why some children outgrow their food allergies and others don’t.
“Further research is needed to identify the endogenous and exogenous factors that may be associated with the development of resistance,” she said.
Abelard said she and her colleagues are currently analyzing FORWARD’s larger child population, which includes four large tertiary care centers in urban areas.
“This study focused on one laboratory at Rush University Medical Center and was a pilot preliminary analysis,” Abelard said. “We are currently conducting further studies to further confirm these findings and identify other predictors of resistance.”
But Abelard also said the large association between insurance type and food allergies in adulthood likely points to social determinants of health influencing outcomes. .
“Suboptimal follow-up and monitoring may help explain, at least in part, the observed differences,” Abelard said.
Children with Medicaid and public insurance, especially those from disadvantaged racial and ethnic groups, may face barriers to care due to lack of insurance and coverage gaps that reduce access to health care. She explained that there is.
“Caregivers may make decisions in anticipation of losing coverage and may want to reduce the number of follow-up visits,” Abelard says.
Additionally, insurance plans don’t cover all health-related financial expenses, such as transportation costs, lost work time for caregivers, and lifestyle changes, she said.
“There may be fewer resources within the family, including low income, limited education, language skills, and health literacy,” Abelard says.
Abelard said further analysis is needed to confirm these findings, but the results are not only interesting but encouraging, as some children with food allergies may develop clinical tolerance. He said that.
We also need to consider how social determinants of health may influence health outcomes, he continued. “Patient and caregiver education is important, and physician awareness of the social determinants of health is important,” Abelard said.
“Keeping in mind health disparities, further identification of children who develop clinical tolerance can be achieved through targeted approaches and proactive measures that involve and regularly monitor children with food allergies and their parents. It could be possible,” she said. “We need more long-term data.”
Arabduljabar S, et al. Summary P189. Presentation location: ACAAI Annual Academic Conference; from November 9th to November 13th, 2023. Anaheim, California.
Disclosure: Abelard does not report any relevant financial disclosures.