Improvement in Health-Related Quality of Life in Food-Allergic Patients: A Meta-Analysis

Shu Cao; Matteo Borro; Sarah Alonzi; Sayantani Sindher; Kari Nadeau; R Sharon Chinthrajah

doi:10.1016/j.jaip.2021.05.020

Improvement in Health-Related Quality of Life in Food-Allergic Patients: A Meta-Analysis

J Allergy Clin Immunol Pract. 2021 Oct;9(10):3705-3714. doi: 10.1016/j.jaip.2021.05.020. Epub 2021 Jun 2.

Authors

Shu Cao¹, Matteo Borro², Sarah Alonzi³, Sayantani Sindher⁴, Kari Nadeau⁴, R Sharon Chinthrajah⁵

Affiliations

¹ Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, Calif.
² Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, Calif; Clinical Immunology Unit, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy; Department of Internal Medicine, San Paolo Hospital, Savona, Italy.
³ Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, Calif; Department of Psychology, Loyola University, New Orleans, La.
⁴ Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, Calif; Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, Calif.
⁵ Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, Calif; Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, Calif. Electronic address: schinths@stanford.edu.

Abstract

Background: Food allergy (FA) is a growing global problem that can affect patients' health-related quality of life (HRQoL) owing to increased anxiety as well as social and economic restrictions. Interventions such as oral food challenges (OFCs) and oral immunotherapy (OIT) have been shown to improve HRQoL. However, meta-analyses and systematic synthesis of these data are lacking.

Objective: To review and quantitatively synthesize potential benefits of interventions (OIT and OFC) systematically to address FA to a variety of foods.

Methods: We conducted a systematic search through PubMed and Cochrane Medical Library databases and performed a meta-analysis focusing on studies assessing changes in HRQoL after OIT and/or OFCs in FA participants and caregivers from 2010 to July 2020. Random effects model and I² statistics were used to assess overall intervention effects and heterogeneity across studies.

Results: We included 13 publications in this meta-analysis (OIT = 7; OFCs = 6). Mean change in HRQoL scores after OIT and OFCs was -1.25 (P < .001) and -0.78 (P = .052), with a significant I² of 87% (P < .001) and 90% (P < .001), respectively. Five OIT studies found significant improvements in HRQoL in the OIT group compared with the placebo group, with an overall standardized mean difference of -0.56 (P = .007; I² = 42%, P = .099).

Conclusions: This meta-analysis showed that in FA patients, both OIT and OFCs are associated with an improvement in HRQoL. Well-designed and long-term HRQoL studies are necessary to ascertain sustained benefits of OIT and OFCs.

Keywords: Food allergy; Meta-analysis; Oral food challenge; Oral immunotherapy; Quality of life questionnaires.

Publication types

Meta-Analysis
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Administration, Oral
Allergens
Desensitization, Immunologic
Food Hypersensitivity*
Humans
Quality of Life*

Substances

Allergens

Abstract

Publication types

MeSH terms

Substances

Grants and funding