Among Those Surveyed, One in Seven Peanut-Allergic Adults First Developed Symptoms in Adulthood

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Prevalence study examining peanut allergy characteristics in adults was scheduled to be presented at the 2020 AAAAI Annual Meeting.

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“We wanted to examine not only the prevalence but the characteristics of peanut allergy in adult populations compared to pediatrics to see what similarities and differences occur.” - Ruchi S. Gupta, MD, MPH

A nationally-representative survey has determined that the prevalence of self-reported peanut allergy in adults in the United States is 2.9%, and that 14.3% of those adults with physician-diagnosed peanut allergy reported symptoms beginning in adulthood. This news comes from a study that was originally scheduled for presentation at the 2020 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI). The 2020 AAAAI Annual Meeting was cancelled due to the situation with coronavirus disease 2019 (COVID-19).

“While peanut allergy is a well-known cause of anaphylaxis and is well-studied, particularly in a pediatric population, less is known about how prevalent peanut allergy is in adults,” said Ruchi S. Gupta, MD, MPH, one of the authors of the study. “We wanted to examine not only the prevalence but the characteristics of peanut allergy in adult populations compared to pediatrics to see what similarities and differences occur.”

The cross-sectional food allergy survey was conducted over the phone and web from 2015 to 2016. The nationally-representative complex-survey weighted data came from a total of 40,443 adults. Self-reported food allergies were only coded as “convincing” if the symptoms were consistent with an IgE-mediated reaction history to the reported food.

Based on the survey, the prevalence of current self-reported peanut allergy was 2.9% in adults in the United States. Of those, 1.8% were determined to have convincing peanut allergy and 1.3% had convincing peanut allergy that had been diagnosed by a physician.

While emergency department visits in the past year were similar for those with childhood-onset peanut allergy compared to those with adult-onset peanut allergy, those with adult-onset peanut allergy were significantly less likely to have an epinephrine prescription compared to their counterparts (43.8% and 55.8% respectively). Additionally, 48.1% of adults with childhood-onset peanut allergy reported ever using an epinephrine auto-injector compared to 35.1% of those with adult-onset peanut allergy.

Only 58.9% of respondents with adult-onset peanut allergy reported being diagnosed by a physician compared to 75.4% of respondents with childhood-onset peanut allergy. This demonstrates a critical gap in care that needs to be addressed for adults suffering from peanut allergy symptoms.

“The next step is to determine whether there are important phenotypic differences in peanut allergy between childhood-onset and adult-onset cases,” said epidemiologist and study co-author Christopher Warren, PhD. “If key differences are discovered, it could improve our understanding of factors that may precipitate adult peanut allergy which in turn can advance food allergy prevention efforts and improve disease management for patients. In the meantime, we hope this prevalence study helps to inform the public about the increasing ubiquity of adult-onset peanut allergy and the importance of consulting an allergist/immunologist to definitively diagnose any suspected food allergies.”

Visit aaaai.org to learn more about food allergies. This research was published in an online supplement to The Journal of Allergy and Clinical Immunology.

The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has over 7,000 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.

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