Munblit Daniel, Apfelbacher Christian, Demidova Anastasia, DunnGalvin Audrey, Boyle Robert J
Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Curr Opin Allergy Clin Immunol. 2025 Jun 1;25(3):172-184. doi: 10.1097/ACI.0000000000001074. Epub 2025 Apr 21.
This review explores the clinical outcomes used in immunoglobulin E (IgE)-mediated food allergy (FA) intervention studies, emphasizing unmet need for patient-centred outcomes. Standardizing outcome measurement is critical as research into FA treatments, particularly food immunotherapy, expands. Here we discuss how outcomes should reflect the multidimensional impact of FA on people's lives.
Current evidence reveals a discrepancy between clinical trial outcomes and those most valued by patients and carers. While trials often prioritize changes in reactivity thresholds or immunological markers, patients and carers emphasize need in reducing severe reactions, improving quality of life, and enhancing confidence in disease management. This disparity highlights importance of harmonization efforts to guide FA research.The Core Outcome Measures for Food Allergy (COMFA) initiative recently identified two core outcomes - 'allergic symptoms' and 'quality of life' - through an international consensus process involving patients, caregivers, clinicians, and researchers. Outcomes like 'desensitization' and 'remission/sustained unresponsiveness' were considered important but were not seen as the most critical.
Developing and implementing a COS for FA intervention studies is essential to align research with patient priorities, ensuring meaningful improvements in routine clinical care. Standardized outcome measurement will generate robust evidence, inform clinical practice, and empower patients and caregivers in decision-making about FA management.
本综述探讨了免疫球蛋白E(IgE)介导的食物过敏(FA)干预研究中使用的临床结局,强调了以患者为中心的结局的未满足需求。随着对FA治疗,尤其是食物免疫疗法的研究不断扩展,标准化结局测量至关重要。在此,我们讨论结局应如何反映FA对人们生活的多维度影响。
目前的证据显示临床试验结局与患者及护理人员最看重的结局之间存在差异。虽然试验通常优先考虑反应阈值或免疫标志物的变化,但患者和护理人员强调需要减少严重反应、改善生活质量以及增强疾病管理信心。这种差异凸显了协调努力对指导FA研究的重要性。食物过敏核心结局指标(COMFA)倡议最近通过一个涉及患者、护理人员、临床医生和研究人员的国际共识过程,确定了两个核心结局——“过敏症状”和“生活质量”。“脱敏”和“缓解/持续无反应性”等结局被认为很重要,但并非最关键的。
为FA干预研究制定和实施核心结局指标对于使研究与患者优先事项保持一致至关重要,可确保在常规临床护理中取得有意义的改善。标准化结局测量将产生有力证据,为临床实践提供信息,并使患者和护理人员在FA管理决策中更有自主权。