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Epidemiology of Clinical Oral Food Challenges (OFC) at Baylor College of Medicine/Texas Children's Hospital (TCH) Food Allergy Program: A Retrospective Chart Review
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Kwei Akuete, MD, MPH, Danielle Guffey, MS, Charles G Minard, PhD, Maria G. Buheis, MD, Kristin H. Dillard, MD, I. Celine Hanson, MD FAAAAI, Lenora M. Noroski, MD, MPH, Filiz O. Seeborg, MD, MPH, Carla M. Davis, MD FAAAAI

Rationale: Currently, little is known regarding the use of OFCs in clinical practice settings. Data from the TCH-Allergy/Immunology clinic over 6 years is reported to understand the use of OFCs in clinical practice.

Methods: OFC data was collected from 2008 through 2013 using the electronic medical record system. Descriptive statistics were used to assess patient demographics and clinical characteristics. The food challenged, specific IgE(sIgE), total IgE, and outcome comparisons between years were tested using Chi-square test, Fisher’s exact test, or Kruskal-Wallis test.

Results: A total of 258 OFCs were performed in a clinical, non-research setting from 2008 through 2013. The number of challenges varied by year, with 69% performed in 2011-2013(p=0.002). Specifically, the percentage of baked food challenges increased over time from 3%(2008) to 25%(2013)(p=0.006). FPIES varied by year with the highest percentage of challenges noted in 2010(N=9/34;p=0.002). Patient total IgE and sIgE values significantly varied over time (p=0.011 and p=0.001, respectively) with the highest median values occurring in 2011. The OFC passage rate did not vary significantly over time (p=0.43). Overall, 84%(N=213/258) passed the food challenge.

Conclusions: Our data shows that the number of patients undergoing OFCs has increased in this center with 84% of patients passing. The increase in the proportion of baked food challenges highlights a trend of physicians to introduce baked milk and egg into the diet of milk/egg allergic patients.  This observation coupled with the high pass rate of OFCs indicates it is safe to perform OFCs in a clinical setting with positive sIgE and total IgE values.