Department of Allergy and Immunology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
Emory University and Children's Healthcare of Atlanta, Atlanta, Ga.
J Allergy Clin Immunol Pract. 2023 Aug;11(8):2330-2334. doi: 10.1016/j.jaip.2023.03.060. Epub 2023 May 24.
Food oral immunotherapy (OIT) is an active form of treatment for food allergies. Although research in this area has been ongoing for many years, the first US Food and Drug Administration-approved product for peanut allergy treatment became available only in January 2020. Limited data exist on OIT services offered by physicians in the United States.
This workgroup report was developed to evaluate OIT practices among allergists practicing in the United States.
The authors developed an anonymous 15-question survey and was subsequently reviewed and approved by the American Academy of Allergy, Asthma & Immunology Practices, Diagnostics and Therapeutics Committee before distribution to the membership. The American Academy of Allergy, Asthma & Immunology electronically distributed the survey to a random sample of 780 members in November 2021. In addition to questions specific to food OIT, the survey included questions on demographics and professional characteristics of the responders.
A total of 78 members completed the survey, yielding a 10% response rate. Fifty percent of responders were offering OIT in their practice. There was a significant difference in experience in OIT originating from research trials in academic versus nonacademic centers. Generally, OIT practices were similar in both settings for the number of foods offered, the performance of oral food challenges before initiating treatment, the number of new patients to whom OIT was offered to per month, and age groups OIT to whom was offered. Almost all of the reported barriers to OIT were similar between settings: staff and time limitations, concerns about safety and anaphylaxis, the need for more education on how to perform, inadequate compensation, and that it was not a significant demand from patients. Clinic space limitations were significantly different and more prominent in academic settings.
Our survey revealed interesting trends in the practice of OIT across the United States, with some significant differences arising when academic and nonacademic settings were compared.
食物口服免疫疗法（OIT）是治疗食物过敏的一种积极治疗方法。尽管该领域的研究已经进行了多年，但美国食品和药物管理局批准的第一种用于治疗花生过敏的产品直到 2020 年 1 月才上市。目前，关于美国医生提供的 OIT 服务的数据有限。
本工作组报告旨在评估在美国执业的过敏症专家进行 OIT 的情况。
作者开发了一个匿名的 15 个问题的调查，并在提交给会员之前，由美国过敏、哮喘和免疫学会实践、诊断和治疗委员会进行了审查和批准。美国过敏、哮喘和免疫学会于 2021 年 11 月向其会员中的随机样本电子分发了该调查。除了针对食物 OIT 的具体问题外，该调查还包括对应答者的人口统计学和专业特征的问题。
共有 78 名成员完成了调查，应答率为 10%。50%的应答者在其诊所提供 OIT。在学术中心和非学术中心开展的 OIT 研究试验的经验方面存在显著差异。通常，在提供的食物数量、开始治疗前进行口服食物挑战的次数、每月提供 OIT 的新患者数量以及提供 OIT 的年龄组方面，两种环境下的 OIT 实践都相似。报告的 OIT 障碍几乎在所有环境中都相似：人员和时间限制、对安全性和过敏反应的担忧、对如何进行操作的更多教育的需求、补偿不足，以及患者对此没有明显需求。诊所空间限制在学术环境中差异显著且更为突出。
我们的调查揭示了美国 OIT 实践中的有趣趋势，当比较学术和非学术环境时，出现了一些显著差异。
