Management and disease burden of children and adults with severe IgE-mediated food allergy: Are adults the lost population?

Background: Lacking causal treatment options in most cases, severe IgE-mediated food allergies (IgE-FA) are associated with a high burden of disease due to permanent risk of anaphylactic reactions after accidental allergen ingestion. To date, only few data comparing health resources and burden of disease between the pediatric and adult population are available.

Objective: Our survey aimed to assess the care situation of pediatric and adult patients with severe, self-reported physician-diagnosed IgE-FA.

Methods: The survey was conducted via an online questionnaire consisting of 32 items covering participant demographics, comorbidities, triggers, utilization of health resources, current management and burden of disease of FA, according to age groups (<18 years: proxy report by parents or ≥ 18 years: self-report by adults).

Results: A total of 367 participants (n = 237 children/parents, n = 130 adults) with self-reported physician-diagnosed IgE-FA and physician-prescribed adrenalin autoinjector were enrolled. Emergency training and having an emergency action plan were significantly more common in the pediatric group (81.4%) than in the adult group (36.2%). Children had clearer medical contact points (pediatrician or [pediatric] pulmonologist, 89.0%), while adults visited a variety of specialized physicians according to their FA-related symptoms. Adults were more unsatisfied with their overall coping-strategy for allergen avoidance (18.5%), daily FA management (27.9%), and treating physician (34.4%) than the pediatric group (2.6%/17.0%/14.8%, respectively, p < 0.05).

Discussion: Our data reveal a general undersupply for severe IgE-FA in Germany, with adults being significantly more affected. This may lead to the reported higher burden of disease in this age group. Increasing clearer medical contact points (eg, qualified allergologists specialized in food allergy)-especially for the adult patient population, finding available therapeutic options for this group of patients, and increasing the awareness of severe food allergy in the general population might overcome this problem.