For the first time, a group of academics from McMaster University has formulated protocols aimed at guiding families eager to enhance their children’s resilience against common food allergens.
These global protocols were unveiled on 8 April in the Journal of Allergy and Clinical Immunology, detailing the methods for standardising the preparatory steps for families contemplating oral immunotherapy. This treatment involves administering minuscule quantities of an allergen, like peanuts, to individuals and incrementally increasing the dosage to bolster their tolerance.
The team of researchers highlighted the previous lack of evidence-based advice available for clinicians advising parents on this procedure for their children. They emphasised that the new protocols address a significant void, considering the therapy’s inherent risks. It is conducted daily at home, with parents playing a quasi-medical role, monitoring reactions, and determining the appropriate interventions.
Douglas Mack, the principal author of the study and an Assistant Clinical Professor in McMaster’s Department of Pediatrics, remarked, “This is a landmark paper in our field because it has never been done before and this process has never been standardised. We’re in dear need of having some kind of guidance on how to approach oral immunotherapy. We simply have not had this before.”
The protocols offer numerous recommendations for families aiming to increase their child’s tolerance to widespread food allergens, including:
- Implementing a comprehensive standardised education programme for patients and caregivers, complete with a thorough consent process
- Ensuring proper parental oversight of dosing prior to initiating treatment
- Recognising contraindications such as unmanaged asthma, a reluctance to use epinephrine, unresolved psychological issues, and pregnancy
- Clearly defining the objectives of the patient and caregiver
- Formulating a standardised universal consent document template
To formulate these recommendations, a panel of 36 international experts in oral immunotherapy identified over 250 consensus statements as critical for clinicians prescribing oral immunotherapy and 71 statements to guide the creation of a consent document for families. With this research, the authors have suggested a uniform protocol for clinicians in preparing patients. Moreover, they have developed a standard consent document for clinicians to ensure patients are fully informed about the therapy’s risks, benefits, and alternatives.
“These families must administer the therapy every single day. That’s why these guidelines are so important. Safety can be optimised to ensure they comprehend the commitment they are making, while being fully informed about the potential serious side-effects,” Mack added.