Self-reported food allergy-associated anxiety during oral immunotherapy declines with time

Few studies have evaluated the daily emotional burden of food allergy (FA) anxiety for patients undergoing oral immunotherapy (OIT). We investigated changes in subjective anxiety for patients during OIT participation and provide suggestions for further clinical study to understand the link between anxiety and OIT treatment adherence, perceived success, and coping mindset. Participants undergoing daily OIT treatment in two ongoing, IRB approved, phase 2 FA clinical trials reported daily anxiety scores. Participants were asked to quantify their daily anxiety about their food allergy on a scale (0 to 100). A mixed-effect linear regression model was constructed to evaluate the daily anxiety scores including days since OIT start, baseline demographics, clinic characteristics, and symptoms with daily dosing. 118 participants have been enrolled in two studies; 66 (56%) participants reported daily anxiety scores (median age [range]: 13 [7-48] years, 48% male, 8% Hispanic). Participants reported a decline in daily anxiety level over time (p=0.017), and participants with symptoms reported a higher anxiety score (p<0.001). There were no other baseline demographics or clinic characteristics found to be associated with the decline in anxiety scores. OIT holds promise as a disease-modifying treatment for FA. Understanding the effects of patient experience during OIT may help to improve treatment adherence and outcomes. Our findings underscore that anxiety levels decline with ongoing OIT treatment. Future studies should identify the factors that contributed to the reduction in anxiety and seek strategies to further reduce the emotional burden of FA and the burden of FA treatment.