Assessing Allergist Supervised Pediatric Oral Food Challenge Outcomes Based on Race and Ethnicity.

Background: Research has shown evidence of differences in the prevalence and management of food allergies based on race and ethnicity. Previous epidemiologic studies have focused on patient-reported food allergies, which may be skewed due to subject recall bias, health literacy regarding the different types of adverse food reactions, and access to allergists/immunologists.

Objective: The primary objective was to evaluate for differences in oral food challenge (OFC) outcomes by race and ethnicity. Secondary objectives included (1) assessment for racial differences between the population who underwent OFCs and that of the general food allergy clinic and (2) the overall pass rates for challenged foods.

Methods: This study utilized OFCs recommended and performed by board-certified allergists from 2003 to 2023.

Results: A total of 11,945 OFCs were performed over the course of 20 years in a large academic center. After excluding equivocal results, 11,869 OFCs were analyzed. Overall, OFC outcomes did not vary based on race or ethnicity. Differences between the self-reported race of the cohort who underwent OFCs and that of the general food allergy clinic population were observed. The pass rates for major food allergens varied from 59.0% to 100%. The lowest pass rate was observed with wheat and the highest with fish and shellfish.

Conclusions: This study demonstrates that there are no differences in OFC outcomes by race or ethnicity. Therefore, allergists should not consider these demographic factors when recommending an OFC. Further research is needed to understand why there were observed differences between the demographic characteristics of the general food allergy clinic population and those of the population who underwent OFCs.