Severe Reaction Rates Increasing in Young Patients With Peanut Allergy

The comorbidity burden in young patients with peanut allergy is high, along with severe reaction rates and frequency of emergency room visits.

This article is part of MPR‘s coverage of the American Academy of Allergy, Asthma & Immunology annual meeting, taking place in San Francisco, California. Our staff will report on medical research related to asthma, allergy, and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from AAAAI 2019.

SAN FRANSISCO — The comorbidity burden in young patients with peanut allergy is high, along with severe reaction rates and frequency of emergency room (ER) visits, according to research presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting, held February 22-25, 2019, in San Francisco, California.

The current study was designed to better understand the poly-allergy and comorbidity disease burden in patients with peanut allergy (ages 4- 17 years) by analyzing data from the proprietary, longitudinal patient claims database, PatientSource™ (PS™). International Classification of Diseases (ICD)-9 and -10 codes were used to identify patients with peanut allergy as well as comorbidities and poly-food-allergies.

Severe reactions were defined using “Sampson criteria” codes, including peanut allergy-related ER visits, hypersensitivity symptoms involving ≥2 organ systems (cutaneous, conjunctival, gastrointestinal, respiratory), and anaphylaxis due to peanut exposure, or symptoms of anaphylaxis (acute respiratory failure, cyanosis, hypotension). Adjustments were applied for ~30% peanut allergy diagnosis undercoding and <100% claims capture rate.

Out of approximately 1.25 million peanut allergy cases, 720,490 patients were followed from January 2011 to December 2017. The most common comorbidities were asthma (61%) and eczema (63%), with 42% of patients having both eczema and asthma. Severe reactions were most common among patients with multiple comorbidities (51% peanut allergy only; 49% peanut allergy and asthma; 58% peanut allergy and eczema; 61% peanut allergy, eczema, and asthma).

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Multiple food allergies were present in 35% of patients and the incidence of severe reactions increased with poly-food allergies (peanut allergy only: 47%; peanut allergy and 1 food allergy: 65%; peanut allergy and 2 food allergies: 67%; peanut allergy and 3 food allergies: 77%; peanut allergy and 4 food allergies: 92%). Approximately 20% of patients (n=144,883) experienced ≥1 peanut-related ER visit and 6% (n=45,261) had multiple ER visits.

“Management of [peanut allergy] beyond avoidance measures is needed to improve healthcare burden and [quality of life],” The researchers concluded.

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Mahr TA, Lieberman JA, Haselkorn T, et al. High comorbidity burden and rates of severe reactions in young patients with peanut allergy.  Presented at: 2019 American Academy of Allergy, Asthma & Immunology Annual Meeting; February 22-25, 2019; San Francisco, CA. Abstract 478.