Allergy & Immunology Evidence Evolution

5 evidence evolution narratives tracing how landmark trials and guideline updates reshaped allergy & immunology practice.

Peanut Allergy Prevention

From avoidance dogma to early introduction

Avoidance → LEAP (2015) → early introduction → Du Toit follow-up → guideline reversal

From lifetime avoidance to safe delabeling

Lifetime avoidance → skin testing → direct oral challenge → delabeling protocols → stewardship impact

Beyond antihistamines

Antihistamines ceiling → omalizumab (ASTERIA/GLACIAL) → remibrutinib → ligelizumab

From subcutaneous shots to sublingual tablets

SCIT → SLIT tablets (GRASS, MERIT) → OIT for food allergy → epitope-focused

From IM debate to intranasal innovation

IM vs SC → auto-injector → dosing by weight → intranasal epinephrine