THURSDAY, March 12, 2026 (HealthDay News) -- Reaction severity does not significantly differ between children with food allergy and asthma failing an oral food challenge (OFC) who are taking inhaled corticosteroid (ICS) alone or in combination with long-acting β-agonist (LABA), according to a study published online Jan. 18 in the Annals of Allergy, Asthma & Immunology.
Kyle Robillard, M.D., from University of Texas Southwestern Medical Center in Dallas, and colleagues retrospectively reviewed patients aged 22 years and younger with positive ("failed") OFC results between January 2017 and April 2023 to evaluate the association between LABA use and OFC reaction severity. The analysis included 91 patients with asthma and food allergies who completed 108 OFCs (55 patients on ICS only who completed 66 OFCs and 36 patients on ICS/LABA who completed 42 OFCs).
The researchers found that the Consortium for Food Allergy Research (CoFAR) reaction grade for both groups was most frequently a 2 or 3, with 81.8 percent (54 patients) of the ICS group and 71.5 percent (30 patients) of the ICS/LABA group being grade 2 or 3. No grade 5 (death) reactions occurred. In the ICS group, epinephrine was administered to 42.4 percent (28 patients) versus 57.1 percent (24 patients) in the ICS/LABA group. Very few patients required three or more epinephrine doses (one versus three participants in the ICS and ICS/LABA groups, respectively). Lower respiratory symptoms were uncommon, with wheezing seen among five and six participants in each group, respectively. The two groups were similar with respect to CoFAR reaction grade, epinephrine use, number of doses of epinephrine administered, and the presence of wheezing during the OFC reaction.
"There has long been concern that LABA medications might mask respiratory symptoms during a food challenge," senior author Bruce J. Lanser, M.D., from National Jewish Health at the University of Colorado School of Medicine in Denver, said in a statement. "These findings suggest that continuing asthma controller therapy may be appropriate in many cases."
Lanser disclosed financial ties to the biopharmaceutical industry.