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Inhalation February 2023 37 Food allergy bravery clinic helps children overcome anxiety According to an article published by PR Newswire and Children's Hospital of Philadelphia, "chil- dren with life-threatening food allergies are taught from an early age to proceed with caution" re- garding food. Protective actions can include "checking labels, ask- ing about ingredients and not eating food at a friend's house" if they do not know whether it con- tains potential allergens. In addi- tion, "that necessary caution can evolve into unnecessary avoid- ance, not only of foods, but of so- cial situations where food might be served. is disordered eating and avoidance is driven by anx- iety and if unaddressed can sig- nificantly derail a child's quality of life and social development." However, the Food Allergy Bravery (FAB) Clinic at Children's Hospi- tal of Philadelphia (CHOP), pro- vides cognitive behavioral therapy (CBT) to treat children who have severe food allergy-related anxiety, helping them "reduce their fears and improve their quality of life." e clinic was established in 2018 as the first of its kind and is avail- able to children and adolescents of all ages. Children's Hospital of Philadel- phia is a non-profit, charitable organization. Founded in 1855 as the first pediatric hospital in the United States, its pediatric research program is among the largest in the country. Repeated brave practices Patients receive individualized treatment in five to eight sessions, led by an allergy practitioner or mental health provider, which focus on "repeated 'brave prac- tices' to encourage the child to take small steps towards facing allergen-related fears and building confidence around food and social situations." Tasks can include "sniffing an allergen, touching an w w w.bbc.com/news/world- us-canada-63788730. • Ne st lé reconsiders pea nut allergy program two years after $2.6B buyout. Nicole DeFeu- dis. Endpoints News. Novem- ber 29, 2022. https://endpts. com/nestle-reconsiders-peanut- allergy-program-two-years-after- 2-6b-buyout. • FDA approves first drug for treatment of peanut allergy for children. January 31, 2020. https://w w w.fda.gov/news- events/press-announcements/ fda-approves-first-drug-treat ment-peanut-allergy-children- #:~:text=FDA%20approves%20 f i r s t %2 0 d r u g %2 0 f or %2 0 treatment%20of%20peanut % 2 0 a l l e r g y % 2 0 f o r % 2 0 children,-Share&text=Today %20t he%20U. S.%20Food %20and,with%20accidental % 2 0 e x p o s u r e % 2 0 t o % 2 0 peanuts. allergy research and drug develop- ment space, perhaps providing a "cautionary tale" for manufactur- ers considering investing in food allergy therapeutics. Stacey Sturner, who has a child with a peanut allergy, manages the Facebook group "Food Allergy Treatment Talk," providing a forum for experts and families to discuss allergy therapies. "ere remains a massive disconnect between what investors want and what the food allergy community needs," she told BBC News. References Content for this article was based on and excerpted from: • Pe a nut a l le r g ie s: Pa r e nt s worr y a f ter Pa lforzia drug sales flop. Madeline Halpert. BBC News, Washington, DC. December 2, 2022. https:// FDA approves first drug for treatment of peanut allergy in children In January 2020, the US Food and Drug Administration (FDA) approved Palforzia [Peanut (Arachis hypogaea) Allergen Powder-dnfp] "to mitigate allergic reactions, including anaphylaxis, that may occur with accidental exposure to peanuts" for use in children ages 4 through 17. An FDA news release noted that "when used in conjunction with peanut avoidance, Palforzia pro- vides an FDA-approved treatment option to help reduce the risk of these allergic reactions in children with peanut allergy." Palforzia was described by the FDA as "a powder manufactured from peanuts and packaged in pull- apart color-coded capsules for Dose Escalation and Up-Dosing, and in a sachet for maintenance treatment. The powder is emp- tied from the capsules or sachet and mixed with a small amount of semisolid food—such as apple- sauce, yogurt or pudding—that the patient consumes." e release provided details about Palforzia usage including "treat- ment with Palforzia consists of three phases: Initial Dose Escalation, Up-Dosing, and Maintenance. e Initial Dose Escalation phase is given on a single day. e Up-Dosing phase consists of 11 increasing dose levels and occurs over several months." "e FDA [required] a Risk Eval- uation and Mitigation Strategy (REMS) with this approval" and included multiple factors to assure safe use. In part, "Palforzia will only be available through specially certif ied hea lthcare providers, healthcare settings, and pharma- cies to patients who are enrolled in the REMS program." Also, "patients or their parents or caregivers must also be counseled on the need for the patients to have injectable epi- nephrine available for immediate use at all times, the need for continued dietary peanut avoidance, and how to recognize the signs and symptoms of anaphylaxis."