Improvement in Health-Related Quality of Life in Food-Allergic Patients: A Meta-Analysis

BACKGROUND: Food allergy (FA) is a growing global problem that can affect patients' health-related quality of life (HRQoL) owing to increased anxiety as well as social and economic restrictions. Interventions such as oral food challenges (OFCs) and oral immunotherapy (OIT) have been shown to improve HRQoL. However, meta-analyses and systematic synthesis of these data are lacking. OBJECTIVE: To review and quantitatively synthesize potential benefits of interventions (OIT and OFC) systematically to address FA to a variety of foods. METHODS: We conducted a systematic search through PubMed and Cochrane Medical Library databases and performed a meta-analysis focusing on studies assessing changes in HRQoL after OIT and/or OFCs in FA participants and caregivers from 2010 to July 2020. Random effects model and I-2 statistics were used to assess overall intervention effects and heterogeneity across studies. RESULTS: We included 13 publications in this meta-analysis (OIT = 7; OFCs = 6). Mean change in HRQoL scores after OIT and OFCs was -1.25 (P < .001) and -0.78 (P = .052), with a significant I-2 of 87% (P < .001) and 90% (P < .001), respectively. Five OIT studies found significant improvements in HRQoL in the OIT group compared with the placebo group, with an overall standardized mean difference of -0.56 (P = .007; I-2 = 42%, P = .099). CONCLUSIONS: This meta-analysis showed that in FA patients, both OIT and OFCs are associated with an improvement in HRQoL. Well-designed and long-term HRQoL studies are necessary to ascertain sustained benefits of OIT and OFCs. (C) 2021 American Academy of Allergy, Asthma & Immunology

Automated summary

This meta-analysis found that both oral immunotherapy (OIT) and oral food challenges (OFCs) are associated with an improvement in health-related quality of life (HRQoL) in patients with food allergies. Further well-designed and long-term studies are needed to confirm the sustained benefits of OIT and OFCs.