Allergy Month in Review | November 2024

The HCPLive team covered a wide variety of developments in the field of allergy during the month of November 2024. A significant number of news stories in the allergy and immunology space, some of which involve new studies, were highlighted by the team in November.

Some examples of the allergy news covered in November included recent findings on allergy prevention through breastmilk, new medical guidance for insurance, a new educational tool for assessing parental use of auto-injectors for anaphylaxis, and a US Food and Drug Administration (FDA) recommendation.

The following list highlights some of the most notable developments in last month’s allergy coverage by HCPLive:

Egg Consumption Through Breast Milk Insufficient for Allergy Prevention in Infants at 12 Months

One notable study in November showed that egg consumption through breast milk at 1 month by an infant aged 12 months is not sufficient for oral tolerance to egg development. This new research also highlighted that eczema at 6 months was shown to be far more associated with the development of egg allergies.

This recent analysis was authored by a team led by Sakurako Kishino, from the department of midwifery and women's health at the University of Tokyo Graduate School of Medicine in Japan. Kishino and colleagues conducted the study to evaluate the effect of maternal egg consumption during the lactation period on offsprings’ development of egg allergy.

Peanut-Sensitized Infants with Eczema Already Co-Sensitized to Tree Nuts

In another story from November, new research suggested that a high number of infants and toddlers who have been peanut-sensitized and have eczema have already been co-sensitized to tree nuts.

These data suggest an increased likelihood of allergic reactions in a sizable number of such patients. Given recent increases in popularity of tree nuts such as cashews in vegan and plant-based diets, tree nut allergies were seen as even more necessary to evaluate.

“Therefore, the aim of this study was to investigate how often peanut-sensitized infants and toddlers are sensitized to cashew, hazelnut and walnut as well as their seed storage proteins, which might be associated with a high risk for clinical reactivity,” the investigators wrote.

Study Finds Supplementation with 2′-Fucosyllactose Effective for Preventing Food Allergy

One notable analysis highlighted from last month showed that supplementation of pregnant mothers using the prominent human milk oligosaccharide 2′-Fucosyllactose (2′-FL) has the potential to allow for food allergy protection in a parent’s offspring. These data align with a prior study which had demonstrated a correlation between 2′-FL’s presence in breastmilk and a lower risk of allergy among infants.

“Taken together, we show, for the first time, that the gestational supplementation with 2′-FL leads to a full protection against [food allergy] in the offspring, which is associated with a microbial imprint and a reinforcement of the gut barrier in the pups,” the investigators wrote.

Tool Used to Assess Parents’ Management of Child Anaphylaxis, Autoinjector Administration

New research led by Laura Polloni of the Food Allergy Referral Centre at Padua University Hospital in Italy demonstrated that the ‘Parental Self-efficacy in Managing Anaphylaxis’ (PSEMA) questionnaire is effective as an evaluation of parents' self-efficacy in their managing of childrens’ anaphylaxis and adrenaline through auto-injectables.

Despite the fact that intramuscular adrenaline via auto-injector is recommended as a treatment for anaphylaxis management within settings outside of a hospital, there has been a notable underutilization of auto-injectors. Therefore, Polloni and colleagues sought to assess the ad-hoc tool for the purposes of understanding ways to support parents in their aim of managing food-induced anaphylactic reactions.

New Medical Guidance Provides Insurance Recommendations for Allergen Immunotherapy

A new set of guidelines were released in November by the American Academy of Allergy, Asthma & Immunology (AAAAI), the American College of Allergy, Asthma & Immunology (ACAAI), and the American Academy of Otolaryngic Allergy (AAOA) for the purposes of allowing clinicians to help insurance companies receive the required documentation for allergen immunotherapies.

Some of the guidelines touch on reasonable documentation requests for CPT codes 95115, 95165, and 95117, including injection details, treatment plans, and physician identities. Other examples of guidelines include recommendations against unnecessary documentation, such as full dosing schedules and previous injection histories, which are known to burden providers and delay access to therapy among patients.

FDA Suggests Removing Oral Phenylephrine as OTC Monograph Nasal Decongestant Ingredient

Another notable November development was that, following a review of existing data, the FDA had proposed the removal of the active ingredient oral phenylephrine within over-the-counter (OTC) monograph drug products for temporary nasal congestion relief. Officials noted that oral phenylephrine had not been shown to effectively diminish users’ nasal congestion.

“It is the FDA’s role to ensure that drugs are safe and effective,” Patrizia Cavazzoni, MD, the director of the FDA’s Center for Drug Evaluation and Research (CDER), said in a statement. “Based on our review of available data, and consistent with the advice of the advisory committee, we are taking this next step in the process to propose removing oral phenylephrine because it is not effective as a nasal decongestant.”