Food allergies are affecting up to 50% more of some segments the U.S. population. According to the Center of Disease Control (CDC), while 1% of the overall population has a food allergy, 8% of children have a food allergy, which is a 50% increase compared to over 20 years ago. Peanut allergy is the most common cause of food triggers for life threatening reactions (called anaphylaxis) and deaths.
Yet, anaphylactic reactions are preventable, so any deaths from these severe allergic reactions to foods are avoidable tragedies.
A comprehensive treatment plan for any food allergy should include:
– accurate diagnosis using skin testing or labs;
– avoiding the trigger food as much as possible;
– and having the anaphylaxis action plan that includes having an spinephrine auto injector device available at all times.
Note, there is no cure for any food allergy.
The U.S. government took a firm step forward in 2006 when the Food Allergen Labeling and Consumer Protection Act became effective. This law requires find manufacturers to label packaged foods that may contain eight food allergens: 1. soy, 2. cow milk, 3. egg, 4. wheat, 5. peanuts, 6. tree nuts, 7. fish, 8. and crustacean shellfish. Caregivers and patients must now read the labels carefully.
Do not be confused by the new advertisements for the manufactured products named AuvidQ and Symjepi. These are automatic injects of epinephrine. They compete with EpiPen. While they offer relief on EpiPen’s former monopolistic pricing, please understand that they all contain the same medication epinephrine. I advise patients and caregivers to select the device that they are most comfortable with while also considering the price.
On January 31, 2020, the FDA announced approval of a new product named Palforzia for use in the management of peanut allergy. <edoa and spca; ,media have erupted wot tax and articles. However, I caution readers, because some of these resources of information contain some misinformation and hype. Palforzia is approved to assist in preventing allergic reactions to peanuts, always with diet avoiding peanuts. Palforzia does not promise to prevent all allergic reactions. This does not improve long-term immunologic tolerance to peanuts, so the underlying potentially fatal allergic reaction remains. Because there is not another therapy, the FDA thought Palforzia could help reduce the severity and rate of allergic reactions in some patients which is still an improvement in the overall situation.
On a practice note, insurance companies may take 6-9 months to approve coverage for Palforzia. Even then, the cost is unknown. The manufacturer has not announced a cash price yet either.
Another product named Viaskin Peanut Patch is under consideration by the FDA. This has the same goal as Palforzia. However, the supporting studies contain different details. This is an area for potential confusion, because people think of this also a treatment of eliminate peanut allergies.
The diagnosis and management of potential fatal food allergies can easily become complex and confusing. Work with your physician early and thoroughly, because you might save a life. Sometimes, additional advice and answers may be necessary from a Board-certified allergist.
Dr. Neil Kao
Allergic Disease and Asthma Center