Retail Food Equivalents for Post-Oral Immunotherapy Dosing in the Omalizumab as Monotherapy and as Adjunct Therapy to Multi-Allergen Oral Immunotherapy in Food-Allergic Children and Adults (OUtMATCH) Clinical Trial.

Bruce J Lanser, Robert Wood, R Sharon Chinthrajah, Brian P Vickery, Jonathan Spergel, Amanda K Rudman Spergel, Scott Sicherer, Wayne Shreffler, Nicole Rogers, Julian Poyser, Marion Groetch, Edwin H Kim, Stacie Jones, J Andrew Bird, Denise C Babineau, Brianna E Gray, Allison Schaible, Margaret Woch, Kim Mudd

Journal: The journal of allergy and clinical immunology. In practice 2023;11(2):572-580.e2

PMID: 37113037

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Abstract

BACKGROUND

Patients with food allergy may be advised to introduce specific foods into their diets, both to increase tolerance gradually and as next steps after completing oral immunotherapy or other therapeutic interventions. However, the safe use of retail foods depends on the ability to establish the specific allergen protein content of these foods.

OBJECTIVE

To develop a systematic approach to estimate the protein content of peanut, milk, egg, wheat, cashew, hazelnut, and walnut in a variety of retail food equivalents for each allergen and associated patient education materials.

METHOD

We created an algorithm that used a multistep process with information from product food labels, nutrient databases, independent weighing and measuring of foods, and information provided by manufacturers, including certificates of analysis, and e-mail communication to estimate the allergen protein content of multiple retail foods for each of seven allergens. Once a variety of retail food equivalents for each allergen and allergen serving size was determined, we developed participant education handouts, which were reviewed by study teams at 10 food allergy centers, the National Institute of Allergy and Infectious Diseases, and the Consortium for Food Allergy Research coordinating center. After 1 year of use, multiple queries were addressed and the retail food equivalents and educational materials were reviewed and edited.

RESULTS

We identified a variety of retail food equivalents for seven allergens at six serving sizes, and created 48 unique patient education materials.

CONCLUSION

Our results provide extensive guidance on a variety of retail equivalents for seven foods, and a method to estimate retail food protein equivalents systematically with ongoing reassessment.

Address: Jaffe Food Allergy Institute, Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: [email protected].; Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Md.; Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif.; Jaffe Food Allergy Institute, Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY.; Translational and Clinical Research Centers, Massachusetts General Hospital, Boston, Mass.; Rho, Inc, Durham, NC.; Division of Allergy and Immunology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas.; Division of Allergy and Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Ark.; Division of Pediatric Allergy and Immunology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC.; Department of Pediatrics, National Jewish Health, Denver, Colo.; Division of Allergy, Immunology and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.; Center for Pediatric Eosinophilic Diseases, Division of Allergy-Immunology, Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pa.; Division of Allergy/Immunology at Emory University and Children's Healthcare of Atlanta, Atlanta, Ga.

DOI: 10.1016/j.jaip.2022.10.022

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MeSH Terms: Adult, Child, Humans, Allergens, Desensitization, Immunologic, Food Hypersensitivity, Nuts, Omalizumab