The study’s findings can help allergists identify those patients with peanut allergy who are experiencing a poorer QOL.
“A severely reduced QOL is the single most significant impact of food allergy on a patient and their family,” explains Mimi LK Tang, PhD. “Therefore, when we are considering effective treatments for food allergy, we need to be striving for treatments that provide meaningful improvement in QOL for patients and families.”
Building on their previous research, Dr. Tang and colleagues were interested in whether certain patient-specific (individual) factors could have a greater impact on QOL, and therefore identify patients who might need more support in managing their allergy or may benefit more from a treatment that improves QOL. The goal, according to Dr. Tang, is to be able to tailor therapies to patients, offering them personalized care.
“We know that QOL is influenced by various patient-specific factors such as age or being allergic to multiple foods,” Dr. Tang says. “However, there are no studies that have examined whether the type of symptoms a patient experiences when they react to their food allergen or the sensitivity level of the patient to their allergen (amount they react to) might also contribute to impaired QOL.”
Exploring Difficult-to-Treat & “Frightening” Symptoms
For a study published in The Journal of Allergy and Clinical Immunology: In Practice, Dr. Tang and colleagues examined whether health related QOL for children with peanut allergy was related to their reaction-eliciting threshold (amount of peanut that triggers a reaction) or the type of symptoms they experience during an allergic reaction. They used data from a 200-patient randomized trial evaluating two novel oral immunotherapies. QOL was assessed using a validated food allergy–specific QOL measurement tool, the Food Allergy Quality of Life Questionnaire Parent Form (FAQLQ-PF; Table). “We also had information on past allergic reaction symptoms and the child’s reaction-eliciting dose in a double-blind placebo-controlled food challenge performed at the time of enrollment into the study,” Dr. Tang says. “We then assessed links between the selected factors and health related QOL using linear regression analysis.
Some allergic symptoms are difficult to treat (eg, abdominal pain and vomiting) or are frightening (eg, breathing difficulty, or multiple systems being involved), Dr. Tang notes. “We hypothesized that having these types of reactions might have a greater negative impact on QOL than say isolated skin symptoms that can be treated with over-the-counter antihistamines, and this turned out to be the case.” she says. “Our findings showed that if a patient is having abdominal symptoms with their reactions or if their reactions involve multiple symptoms (skin, airway, gut), they have a poorer QOL compared with people who just have skin involvement.”
Reaction to Smaller Amount of Allergen Linked to Poorer QOL
The study team’s findings also show that patients who react to smaller amounts of allergen have poorer QOL than those who have a higher reaction threshold. “This information can help allergists identify those patients with peanut allergy who are experiencing a poorer QOL and might need more support in managing their allergy or might benefit more from interventions that can improve QOL,” Dr. Tang says.
Dr. Tang and colleagues would like to see more research that is focused on understanding the impact of food allergy on other ‘patient important outcomes’ beyond health related QOL (eg, anxiety or psychological distress), and factors that can modify and improve such outcomes. “The ultimate goal is to develop strategies that can minimize the impact of food allergy on the patient,” Dr. Tang says.
