Exploring novel approaches to food allergy management

Nurse practitioners are likely to encounter pediatric and adult patients with symptoms of food allergy who need an accurate diagnosis, emergency treatment plans, and options for management. The pathophysiology of immunoglobulin E (IgE)-mediated food allergy, current and emerging diagnostics, treatment, and emergency management is briefly reviewed, and promising new and potential future treatment options are discussed. Currently, Food and Drug Administration-approved oral immunotherapy (OIT) treatment for peanut allergy, but clinical trials are underway to explore multiple-allergen OIT and alternate routes for IT such as sublingual and epicutaneous. Treatments that modulate the immune system are also potential treatments for food allergies (FAs), including biologic agents. Omalizumab, an anti-IgE therapy, dupilumab, an interleukin-4Ra receptor monoclonal antibody, and etokimab, an anti-IL-33, are all being studied for the treatment of food allergy. There is hope that these novel therapies for FAs will be a viable option translated to the practice setting in the near future, so that strict avoidance is not the only treatment plan for FAs. Nurse practitioners can support their patients with FAs and their families by keeping abreast of progress in food allergy research and assisting patients to consider novel treatment options, when appropriate, using shared decision making.