INCREASED INCIDENCE AND PREVALENCE OF PEANUT ALLERGY IN CHILDREN AND ADOLESCENTS IN THE UNITED STATES

Introduction Peanut allergy (PA) is associated with high rates of severe reactions and impaired quality of life, yet epidemiologic data are limited. Utilizing a real-world, nationally representative cohort of children/adolescents, we examined incidence and prevalence of PA. Methods Longitudinal data between January 2011-December 2017 from a geographically and payor-type representative US healthcare claims database were utilized. Patients aged 4-17 years with PA were identified using diagnostic codes and/or services indicating PA-associated severe reactions/anaphylaxis. Prevalence estimates were projected, accounting for dataset capture rates by healthcare setting (40% outpatient clinic, 25% hospital), 30% under-coding, and patient under-presenting (8-15% based on patient age). Estimated annual incidence was defined as PA births as a proportion of all 1-year-old babies. Incidence was computed from prevalence estimates, aging patients back to age 1, adjusting for spontaneous outgrowth of PA (27% by age 12). Results Estimated prevalence of PA was 1.25 million (2.2%) in 2017. Of these patients, ∼500K were diagnosed by allergists; ∼370K diagnosed by pediatricians and managed by allergists; and ∼380K diagnosed and managed by outside of allergists. Common comorbidities included eczema (63%) and asthma (61%); 35% of PA patients had ≥1 additional food allergy. Annual incidence of PA in 1-year-olds increased, from an estimated 1.7% to 5.2% between 2001-2017 (Figure). Conclusions Approximately 2.2% of children/adolescents in the US have PA. Annual incidence has increased since 2001; current annual incidence in 1-year-olds is ∼5%.  Findings indicate an increase in both incidence and prevalence of PA, suggesting the impact of PA may be greater than previously reported. Figure. Incidence of PA Among 4–17-Year-Olds in the United States Between 2001–2017