豆包成人版app官方免费版 Healthcare Develops Innovative Oral Food Challenge meals for the Paediatric food allergy population

豆包成人版app官方免费版 Healthcare is excited to announce the development of its new range of Oral Food Challenge meals, designed to significantly improve the quality of life for very young children with food allergies. Committed to addressing the critical issues of food allergy diagnosis, enhancing quality of life, and reducing the economic burden of allergies, 豆包成人版app官方免费版 Healthcare continues to lead the way in innovative healthcare solutions.

Food allergies are increasingly prevalent among young children, with studies indicating that approximately 6-8% of the paediatric population is affected. This poses significant challenges for families and healthcare providers alike. 豆包成人版app官方免费版 Healthcare’s innovative Peanut, Milk, and Egg Challenge meals are tailored to meet the needs of children as young as six months, but can also be used for individuals of all ages, including adults. These products have undergone comprehensive development and rigorous testing to ensure their safety and efficacy.

豆包成人版app官方免费版 Healthcare’s paediatric challenge meals will be the only pharma-grade products developed globally, setting a new standard in the industry. This distinction is crucial as it ensures the highest levels of safety, quality, and efficacy for children undergoing food allergy diagnosis and during clinical trials for the development of new treatments. By adhering to stringent pharmaceutical standards, 豆包成人版app官方免费版 Healthcare guarantees that these products meet rigorous regulatory requirements, providing healthcare providers and families with the confidence that they are using the best possible tools for managing food allergies. This global first underscores 豆包成人版app官方免费版 Healthcare’s commitment to innovation and excellence in addressing the critical needs of the paediatric population.

Additionally the importance of considering multiple food allergies in both diagnosis and treatment has become increasingly evident. Many children with food allergies often react to more than one allergen, making it crucial for healthcare providers to adopt a comprehensive approach. The development of challenge meals to multiple allergens at 豆包成人版app官方免费版 Healthcare highlights the significance of addressing an important need in clinical trials. These meals are designed to meet the needs of food allergy research and clinical communities, ensuring safety, quality, and efficacy across various allergens in trial participants from the important paediatric ages through to adult and will be ready by the end of 2026.听

For more information, please contact our commercial team.

Development of standardised challenge meals to meet Regulators demands for Oral Food Challenges

T. Mendes Borges; ML. Martinez Casas; M. Wickham; H. Lett

Our challenges meals (CMs) are used in oral food challenges to support clinical trials, they consist of 3 strengths, a low and a high strength allergen product and importantly a 0% non-allergen CM. The 0% can be used in the placebo arm of a blinded placebo controlled randomised clinical trial.

To ensure safety, quality, and efficacy we have developed these using the Quality By Design (QbD)听 approach.

Standardising the CMs means that we can meet more stringent regulators demands, where there has been a lot of focus on recently.

What is the QbD approach and why is it so important?听

This approach means you predetermine all the requirements for the challenge meal before starting the formulation work. This allows you to develop the product with the required quality target product profile and critical quality attributes, therefore the developed product is fit for its intended use.

For example, the 3 strengths must be comparable in terms of flavour, appearance, and texture, whilst ensuring the allergen remains masked. This is important, neither the the clinician nor the participants are not aware if they are using the non-allergen or allergen containing challenge meal. The masking also reduces the chance of a psychosomatic response in participants if they think that they can taste, see or smell the allergen.

In the next stage of the process, analytical test methods were developed and validated to make sure the product meets the established specifications adhering to current guidelines.

In addition stability studies are conducted to determine the shelf life of the CM.

To conclude, by using the QbD approach, standardised CMs have been developed meeting more stringent health authority鈥檚 requirements.

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Analytical development, validation and standardisation strategy for test methods of challenge meals which are utilised as Oral Food Challenges (OFCs) for the diagnosis and monitoring of food allergies

S. Maudsley; H. Lett; S. Rosborough; H. Payne

The double-blinded placebo controlled food challenge is currently the gold standard for food allergy diagnosis. Within the industry, there is an unmet need to standardise oral food challenges (OFCs) and regulatory authorities are requiring standardisation due to the usage of OFCs in clinical trials, where product safety, quality and efficacy is paramount.

豆包成人版app官方免费版 Healthcare鈥檚 strategy for standardisation of OFCs includes a quality by design approach and analytical testing of critical quality attributes. The quality by design approach is taken during product formulation, where product palatability, masking of allergen and dosing scheme is verified.

The analytical testing of critical quality attributes involves developing and validating test methods according to pharmaceutical guidelines.

Examples of the test methods include (but are not limited to) the following:

• SDS-PAGE 鈥� A method used to identify which allergenic proteins are present in the active substances and the challenge meals. Confirms batch to batch consistency and an indicator of protein stability.
• ELISA 鈥� The method specifically quantifies the amount of allergenic protein present in the challenge meals, confirming product strength.
• In vitro IgE assay 鈥� IgE has an important role in the immune response within allergic individuals. The assay utilises sera from allergic individuals to verify whether the active substance and the challenge meals elicit an immunological response.
• Microbial testing 鈥� To determine whether the challenge meals are free from contamination and are safe for consumption.

In summary, the standardised approach utilised for design and testing of challenge meals ensures product safety, quality and efficacy.

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What Are Oral Food Challenges?

An Oral Food Challenge (OFC) is a diagnostic test use to confirm or rule out food allergies. The process involves the ingestion of a suspected food allergen in incremental quantities under close clinical supervision. [1]

Why are OFCs Used?

OFCs are performed when a patient鈥檚 history and various tests, such as a skin prick test (SPT) or specific IgE tests provided inconclusive results. OFC are a well-established diagnostic tool in determining whether a food allergy persists or has resolved. [2]

Guidelines

The European Academy of Allergy and Clinical Immunology (EAACI) and the British Society for Allergy & Clinical Immunology (BSACI) are some examples for guidelines that help standardise the safe administration of OFCs 鈥� these detail preparation steps, dosing protocols and emergency management [3, 4]

Methods Explained

The most common methods for administering OFC are the following:

• 听 听 听 Single-Blind Placebo-Controlled Food Challenge (SBPCFC). The patient are not aware whether they are receiving the allergen or a placebo, only the clinician has knowledge of this. This method is used when subjective symptoms may influence the outcome 鈥� useful for anxious children or adults who are concerned about being exposed to a certain allergenic food [5]
• 听 听 听 Double-Blind Placebo-Controlled Food Challenge (DBPCFC). In this method both the patient and the clinician are unaware whether the administered food contains allergen or it is a placebo. This approach helps rule out reporting and measurement bias from the observer and psychological effects from the patient. For research purposes, double-blinded food challenges are still considered the gold standard in diagnosing and confirming food allergies [6]
• 听 听 听 Open food challenges are the process of choice when the patients are experiencing objective symptoms, such as angioedema 鈥� sudden swelling of body parts (e.g. face, hands) as a result of viral infection. [7]

Subjective Symptoms

These are difficult to interpret given that they are based on personal opinions and feelings rather than facts. Some of the symptoms may arise from the psychological impact of potential exposure to known allergens, resulting in stress and anxiety. [8]

• 听 听 听 Examples: nausea, irritability, sleeplessness, excitement, apprehension, change of mood/behaviour

Objective Symptoms

These symptoms are more reliable as a marker of body鈥檚 reaction to an allergen 鈥� they can be observed directly as they physically manifest and are usually obvious. [8]

• 听 听 听 Examples: flushing, worsening of eczema, vomiting, blood pressure changes, respiratory difficulties

Confirming a positive food challenge

To confirm a positive diagnosis to an allergen, the OFC process must present with at least 1 of the major criteria or 2 or more of the minor criteria listed below. Some examples of these:

• 听 听 听 Major criteria: hives appearing on more than 3 sites, emergence of angio-oedema, wheezing, dyspnoea and aphonia
• 听 听 听 Minor criteria: some sneezing and congestion, nausea and/or vomiting for under 20 minutes, anxiety, distress, drowsiness [8, 9]

Pros and Cons of OFCs

Positives:

• Highly accurate diagnosis, low risk of bias with double-blind procedures – essential for guiding dietary management鈥�. [2]

• Helps reduce unnecessary food avoidance, improving nutritional status and quality of life鈥�.[3]

• Can provide peace of mind and clarify tolerance levels鈥�. Reduced anxiety around accidental exposure occurring. [3]

Negatives:

• Substantial risk of severe reactions to known allergens including anaphylaxis鈥�. [2]

• Emotional distress for patients, especially children鈥�.[3]

• Time-consuming and resource-intensive鈥�. Highly trained clinical staff are required to observe patients during trial. [6]

• Conditions during OFC may not reflect real-life scenarios where accidental exposure may happen. [4]

References听

1. 听 听 听 Panel, N.-S.E., Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. Journal of Allergy and Clinical Immunology, 2010. 126(6): p. S1-S58.
2. 听 听 听 Nowak-W臋grzyn, A., et al., Work Group report: oral food challenge testing. Journal of Allergy and Clinical Immunology, 2009. 123(6): p. S365-S383.
3. 听 听 听 Stiefel, G., et al., BSACI guideline for the diagnosis and management of peanut and tree nut allergy. Clinical & Experimental Allergy, 2017. 47(6): p. 719-739.
4. 听 听 听 Muraro, A., et al., EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy, 2014. 69(8): p. 1008-25.
5. 听 听 听 Skypala, I. and C. Venter, Food Hypersensitivity: Diagnosing and Managing Food Allergies and Intolerance. 1 ed. 2009, Newark: John Wiley & Sons, Incorporated.
6. 听 听 听 Sampson, H.A., et al., Standardizing double-blind, placebo-controlled oral food challenges: American Academy of Allergy, Asthma & Immunology鈥揈uropean Academy of Allergy and Clinical Immunology PRACTALL consensus report. Journal of Allergy and Clinical Immunology, 2012. 130(6): p. 1260-1274.
7. 听 听 听 Venter, C., et al., Comparison of open and double鈥�blind placebo鈥�controlled food challenges in diagnosis of food hypersensitivity amongst children. Journal of human nutrition and dietetics, 2007. 20(6): p. 565-579.
8. 听 听 听 Niggemann, B., When is an oral food challenge positive? Allergy, 2010. 65(1): p. 2-6.
9. 听 听 听 Joan Gandy, J.G., Manual of Dietetic Practice. Sixth edition. ed. 2019, Newark: Wiley.

What Is A Food Allergy?

A food allergy arises when the immune system incorrectly identifies a specific food or food component, typically a protein, as a harmful substance. This misidentification leads to the production of Immunoglobulin E (IgE) antibodies directly against the food protein. The subsequent activation of IgE triggers the release of histamine, resulting in an allergic symptom that can range from mild discomfort to severe, potentially life-threatening anaphylaxis (Sicherer & Sampson, 2017; Turner et al., 2014).听

听

How common are food allergies? 听

Food allergies are a significant public health concern around the world, with their prevalence increasing globally. They affect up to 8-10% of the population (Warren et al., 2022). Food allergies are more common in children, impacting approximately 8% of children and 4% of adults in the United States (Gupta et al., 2019).听

The prevalence of specific food allergies can vary by region. However, the most common allergies typically include peanuts, which affect about 1-2% of the population in Western countries (ACAAI). Additionally, cow’s milk and egg allergies are prevalent in children, though many of these children eventually outgrow their allergies.听

Research suggests that several factors contribute to the rising incidence of food allergies, including changes in diet, environmental influences, and genetics (Sicherer & Sampson, 2017).听

听

How are food allergies diagnosed?

The gold standard for diagnosing food allergies is the oral food challenge. During this process, a patient consumes increasing amounts of a suspected allergen under close medical supervision to determine their threshold for allergic response (Mustafa et al., 2023).听

Blood tests can measure allergen-specific IgE antibodies related to specific foods (Ansotegui et al., 2020).听

A skin prick test is commonly performed by placing a small drop of an allergen extract on the skin, followed by a prick to assess whether an allergic reaction occurs, indicated by a raised bump that signifies an immediate response (Santos et al., 2023).听

听

Current management of food allergies

The primary treatment for food allergies has been strict avoidance of allergenic foods with individuals having epinephrine auto-injector available to treat a severe allergic reaction. Current treatment for desensitisation has been used such as oral immunotherapy (OTI) and sublingual immunotherapy (SLIT) to build up a tolerance of the allergen. There are emerging therapies currently being studied such as the Atopy Patch Test (Cocco & Sol茅, 2009).听听

References听

Ansotegui, I. J., Melioli, G., Canonica, G. W., Caraballo, L., Villa, E., Ebisawa, M., Passalacqua, G., Savi, E., Ebo, D., G贸mez, R. M., S谩nchez, O. L., Oppenheimer, J. J., Jensen-Jarolim, E., Fischer, D. A., Haahtela, T., Antila, M., Bousquet, J. J., Cardona, V., Chiang, W. C., . . . Zuberbier, T. (2020). IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper. World Allergy Organization Journal, 13(2), 100080. 听

Cocco, R., & Sol茅, D. (2009). Patch test in the diagnosis of food allergy. Allergologia Et Immunopathologia, 37(4), 205鈥�207. 听

Mustafa, S. S., Bress, J., Capucilli, P., Tuong, L. A., Denise-Sanchez-Tejera, N., Patrawala, S., & Ramsey, A. (2023). Outcomes of oral food challenges in a real-world setting, with predictors of outcomes. Annals of Allergy Asthma & Immunology, 131(5), 655鈥�660. 听

Santos, A. F., Riggioni, C., Agache, I., Akdis, C. A., Akdis, M., Alvarez鈥怭erea, A., Alvaro鈥怢ozano, M., Ballmer鈥怶eber, B., Barni, S., Beyer, K., Bindslev鈥怞ensen, C., Brough, H. A., Buyuktiryaki, B., Chu, D., Del Giacco, S., Dunn鈥怗alvin, A., Eberlein, B., Ebisawa, M., Eigenmann, P., . . . Skypala, I. (2023). EAACI guidelines on the diagnosis of IgE鈥恗ediated food allergy. Allergy, 78(12), 3057鈥�3076. 听

Sicherer, S. H., & Sampson, H. A. (2017). Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. Journal of Allergy and Clinical Immunology, 141(1), 41鈥�58. 听

Turner, P. J., Gowland, M. H., Sharma, V., Ierodiakonou, D., Harper, N., Garcez, T., Pumphrey, R., & Boyle, R. J. (2014). Increase in anaphylaxis-related hospitalizations but no increase in fatalities: An analysis of United Kingdom national anaphylaxis data, 1992-2012. Journal of Allergy and Clinical Immunology, 135(4), 956-963.e1. 听

Warren, C. M., Agrawal, A., Gandhi, D., & Gupta, R. S. (2022). The 豆包成人版app官方免费版 population-level burden of cow鈥檚 milk allergy. World Allergy Organization Journal, 15(4), 100644. 听