{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:29:57Z","timestamp":1792466997523,"version":"4.5.0"},"reference-count":59,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T00:00:00Z","timestamp":1642550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is substantial interest in immunotherapy and biologicals in IgE\u2010mediated food allergy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched six databases for randomized controlled trials about immunotherapy alone or with biologicals (to April 2021) or biological monotherapy (to September 2021) in food allergy confirmed by oral food challenge. We pooled the data using random\u2010effects meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 36 trials about immunotherapy with 2126\u00a0mainly child participants. Oral immunotherapy increased tolerance whilst on therapy for peanut (RR 9.9, 95% CI 4.5.\u201321.4, high certainty); cow's milk (RR 5.7, 1.9\u201316.7, moderate certainty) and hen's egg allergy (RR 8.9, 4.4\u201318, moderate certainty). The number needed to treat to increase tolerance to a single dose of 300\u00a0mg or 1000\u00a0mg peanut protein was 2.<\/jats:p><jats:p>Oral immunotherapy did not increase adverse reactions (RR 1.1, 1.0\u20131.2, low certainty) or severe reactions in peanut allergy (RR 1,6, 0.7\u20133.5, low certainty), but may increase (mild) adverse reactions in cow's milk (RR 3.9, 2.1\u20137.5, low certainty) and hen's egg allergy (RR 7.0, 2.4\u201319.8, moderate certainty). Epicutaneous immunotherapy increased tolerance whilst on therapy for peanut (RR 2.6, 1.8\u20133.8, moderate certainty). Results were unclear for other allergies and administration routes.<\/jats:p><jats:p>There were too few trials of biologicals alone (3) or with immunotherapy (1) to draw conclusions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Oral immunotherapy improves tolerance whilst on therapy and is probably safe in peanut, cow's milk and hen's egg allergy. More research is needed about quality of life, cost and biologicals.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.15211","type":"journal-article","created":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T16:59:19Z","timestamp":1641747559000},"page":"1852-1862","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":135,"title":["Allergen immunotherapy and\/or biologicals for IgE\u2010mediated food allergy: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8413-5487","authenticated-orcid":false,"given":"Debra","family":"de Silva","sequence":"first","affiliation":[{"name":"The Evidence Centre  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0783-1988","authenticated-orcid":false,"given":"Pablo","family":"Rodr\u00edguez del R\u00edo","sequence":"additional","affiliation":[{"name":"Ni\u00f1o Jesus University Children's Hospital  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolette W.","family":"de Jong","sequence":"additional","affiliation":[{"name":"University Medical Centre Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2220-7745","authenticated-orcid":false,"given":"Ekaterina","family":"Khaleva","sequence":"additional","affiliation":[{"name":"University of Southampton  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Singh","sequence":"additional","affiliation":[{"name":"The Evidence Centre  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0960-9854","authenticated-orcid":false,"given":"Anna","family":"Nowak\u2010Wegrzyn","sequence":"additional","affiliation":[{"name":"NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5026-5862","authenticated-orcid":false,"given":"Antonella","family":"Muraro","sequence":"additional","affiliation":[{"name":"Padua University Hospital  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9089-4604","authenticated-orcid":false,"given":"Philippe","family":"Begin","sequence":"additional","affiliation":[{"name":"Univerisite de Montreal  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pajno","sequence":"additional","affiliation":[{"name":"Policlinico Hospital\u2010University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2549-0523","authenticated-orcid":false,"given":"Alessandro","family":"Fiocchi","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Childrens\u2019 Hospital IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Sanchez","sequence":"additional","affiliation":[{"name":"AEPNAA Spanish Association for People with Food and Latex Allergy  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Jones","sequence":"additional","affiliation":[{"name":"Allergy UK  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2040-8428","authenticated-orcid":false,"given":"Caroline","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Karolinska Institutet and Sachs\u00b4 Children and Youth Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8940-038X","authenticated-orcid":false,"given":"Carsten","family":"Bindslev\u2010Jensen","sequence":"additional","affiliation":[{"name":"Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5939-812X","authenticated-orcid":false,"given":"Gary","family":"Wong","sequence":"additional","affiliation":[{"name":"Chinese University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1613-8875","authenticated-orcid":false,"given":"Hugh","family":"Sampson","sequence":"additional","affiliation":[{"name":"Mount Sinai School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Beyer","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary\u2010Jane","family":"Marchisotto","sequence":"additional","affiliation":[{"name":"EAACI Patient Organisation Committee Chair  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1748-2328","authenticated-orcid":false,"given":"Montserrat","family":"Fernandez Rivas","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5710-5570","authenticated-orcid":false,"given":"Rosan","family":"Meyer","sequence":"additional","affiliation":[{"name":"Imperial College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5189-4265","authenticated-orcid":false,"given":"Susanne","family":"Lau","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9557-8635","authenticated-orcid":false,"given":"Ulugbek","family":"Nurmatov","sequence":"additional","affiliation":[{"name":"Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2252-1248","authenticated-orcid":false,"given":"Graham","family":"Roberts","sequence":"additional","affiliation":[{"name":"University of Southampton  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the GALEN Food Allergy Guidelines Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12305"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.02.039"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13548"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13287"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2019.10.021"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13124"},{"issue":"4","key":"e_1_2_11_8_1","first-page":"CD010638","article-title":"Oral and sublingual immunotherapy for egg allergy","volume":"4","author":"Romantsik O","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000504366"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2011.03948.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.172460"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13319"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13223-020-0413-7"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.12961"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2019.06.038"},{"key":"e_1_2_11_16_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions version 6.2, February 2021","author":"Higgins JPT","year":"2021"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.026"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12494"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2019.10.014"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.131347"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.01.051"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022613"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30420-9"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2020.06.023"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62301-6"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.09.016"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.10.048"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31793-3"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13148"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(20)30234-0"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812856"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.1113"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2016.08.017"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.16591"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.11.011"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(92)90080-L"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.11.005"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2009.30.3221"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2013.09.001"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2007.10.029"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2011.03749.x"},{"issue":"1","key":"e_1_2_11_42_1","first-page":"12","article-title":"Oral desensitization in children with milk and egg allergies obtains recovery in a significant proportion of cases. A randomized study in 60 children with cow's milk allergy and 90 children with egg allergy","volume":"39","author":"Morisset M","year":"2007","journal-title":"Eur Ann Allergy Clin Immunol"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2010.03.015"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2012.02815.x"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.09.030"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.02.029"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.10.023"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-16730-6"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.13210"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2015.01.017"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2012.01349.x"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12604"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2017.07.007"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.12974"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2016.11.023"},{"issue":"19","key":"e_1_2_11_56_1","first-page":"52","article-title":"Food allergy in children: results of a standardized protocol for oral desensitization","volume":"45","author":"Patriarca G","year":"1998","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01501.x"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.08.041"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.08.027"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2008.01921.x"}],"container-title":["Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.15211","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/all.15211","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.15211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T01:54:12Z","timestamp":1692842052000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/all.15211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,19]]},"references-count":59,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1111\/all.15211"],"URL":"https:\/\/doi.org\/10.1111\/all.15211","archive":["Portico"],"relation":{},"ISSN":["0105-4538","1398-9995"],"issn-type":[{"value":"0105-4538","type":"print"},{"value":"1398-9995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,19]]},"assertion":[{"value":"2021-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}