{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:20:30Z","timestamp":1787926830668,"version":"build-2784847793"},"reference-count":0,"publisher":"Esmon Publicidad, SA","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Investig Allergol Clin Immunol"],"abstract":"<jats:p>Background: Oral food challenge, particularly double-blind placebo-controlled food challenge (DBPCFC), is the gold standard for diagnosis of food allergy, although safety concerns limit its widespread use.\nObjectives: To evaluate the severity of reactions during DBPCFCs and to identify predictors of severe reactions.\nMethods: DBPCFCs from the EuroPrevall outpatient clinic study were analyzed in patients reporting immediate reactions to milk, egg, fish, shrimp, peanut, hazelnut, celeriac, apple, and\/or peach. Patients with prior life-threatening anaphylaxis were excluded. Reaction severity (patient-reported and DBPCFC-elicited) was assessed using the Food Allergy Severity Score. A 2-step modeling strategy based on generalized estimating equations was applied to identify predictors of a positive DBPCFC, and, among positive challenges, predictors of anaphylaxis.\nResults: Among 514 DBPCFCs performed, 190 (36.9%) were negative, 30 (5.8%) uncertain, and 294 (57.2%) positive (102 mild oropharyngeal reactions [19.8%] and 192 systemic reactions [37.4%], of which 160 were moderate and 32 severe). The 32 severe reactions comprised 30 cases (30\/514 [5.8%]) with lower respiratory involvement (16\/30 with cough or dyspnea) and 2 anaphylaxis with hypotension (2\/514 [0.4%]). DBPCFC reactions were less severe than patient-reported reactions (P&lt;.01). Atopic dermatitis and food-specific IgE &gt;0.35 kUA\/L predicted positivity, whereas prior reaction severity and egg challenge were predictors of anaphylaxis.\nConclusion: While systemic reactions during DBPCFCs were frequent, severe anaphylaxis was rare, supporting the safety profile of DBPCFCs when appropriately conducted. Key predictors of reactivity include atopic dermatitis and food-specific sensitization, while prior severity points to a risk of anaphylaxis. These findings may help risk stratification and patient selection in clinical practice.<\/jats:p>","DOI":"10.18176\/jiaci.1217","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:24:33Z","timestamp":1787923473000},"source":"Crossref","is-referenced-by-count":0,"title":["Severity of Reactions in Double-Blind Placebo-Controlled Food Challenges: New Insights From the EuroPrevall Outpatient Clinic Study"],"prefix":"10.18176","volume":"37","author":[{"given":"Rosialzira N","family":"Vera-Berrios","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Gonzalo-Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara K","family":"Ballmer-Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Asero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Barreales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Belohlavkova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"de Blay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Clausen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Jedrzejczak-Czechowicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 C","family":"Knulst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy-My","family":"Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos G","family":"Papadopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todor  A","family":"Popov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayade","family":"del Prado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"Purohit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Reig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Sinaniotis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EN Clare","family":"Mills","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"van Ree","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Fern\u00e1ndez-Rivas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7491","published-online":{"date-parts":[[2026,8,28]]},"container-title":["Journal of Investigational Allergology and Clinical Immunology"],"original-title":[],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:24:34Z","timestamp":1787923474000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jiaci.org\/ahead-of-print\/severity-of-reactions-in-double-blind-placebo--controlled-food-challenges--new-insights-from-the-europrevall-outpatient-clinic-study"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,8,28]]}},"URL":"https:\/\/doi.org\/10.18176\/jiaci.1217","relation":{},"ISSN":["1018-9068","1698-0808"],"issn-type":[{"value":"1018-9068","type":"print"},{"value":"1698-0808","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]}}}