Recommendations

Australasian Society of Clinical Immunology and Allergy

3.
Allergen immunotherapy should not yet be used for routine treatment of food allergy – research in this area is ongoing.

Research into allergen immunotherapy for food allergy is ongoing and until further work determining safety and efficacy is determined, it should not be performed outside of well defined medical research studies, as there is a high risk of potential harm in individuals with severe food allergy.

Allergen immunotherapy is currently only recommended for treatment of allergic rhinitis (hay fever) and sometimes allergic asthma, due to environmental allergens (such as pollen or dust mites) and for the treatment of stinging insect allergy.

Allergen immunotherapy should be considered in appropriate patients when symptoms are severe, the cause is difficult to avoid (such as grass pollen or stinging insects) and medications don't help or cause adverse side effects.

For further information go to www.allergy.org.au/patients/allergy-treatment

Supporting evidence
  • Nurmatov et al, ‘Effectiveness and safety of orally administered immunotherapy for food allergies: a systematic review and meta-analysis’, Br J Nutr. 2014 Jan 14;111(1):12-22. doi: 10.1017/S0007114513002353. Epub 2013 Aug 15.
  • Lucendo et al, ‘Relation between eosinophilic esophagitis and oral immunotherapy for food allergy: a systematic review with meta-analysis’, Ann Allergy Asthma Immunol. 2014 Dec;113(6):624-9. doi: 10.1016/j.anai.2014.08.004. Epub 2014 Sep 10.
  • Wang, J. and H. Sampson, ‘Oral and sublingual immunotherapy for food allergy’, Asian Pac J Allergy Immunol. 2013 Sep;31(3):198-209.
How this list was made How this list was made

The RACP Strategic Policy and Advocacy group assisted ASCIA in compiling the original list of 25 tests, treatments and services, that have been identified either in past work by ASCIA, other literature reviews or in evidence reviews performed by overseas specialist physician bodies or health agencies as being overused, inappropriate or of limited effectiveness.

Two electronic surveys were sent to ASCIA members who are Fellows of the RACP (256 members in total) in February 2015 and March 2015, to firstly rank a top 5 from the list of 25, and secondly to review the wording and rankings of the top 5 recommendations. The overall response rate for these surveys was 20%. All ASCIA members and relevant patient organisations were then invited to review the list.