National Allergy Centre of Excellence established to prevent and manage allergies

Australians and their families living with allergy, along with healthcare providers, teachers, childcare workers and food service providers are all set to benefit from improved understanding and management of allergy and allergic diseases.

Associate Professor Kirsten Perrett, Acting Director of the Centre for Food & Allergy Research and Co-Group Leader of the Institute's Population Allergy group, has welcomed and congratulated the Federal Government on its positive response to the Parliamentary Inquiry into Allergies and Anaphylaxis held in 2020.

The Inquiry, chaired by Mr Trent Zimmerman MP and deputy chair, Dr Mike Freelander MP, made a series of specific recommendations which have now been brought to fruition, with funding announced in the 2022 Federal budget.

Two new allergy organisations have been funded in the budget, that will work together to deliver world-leading initiatives and research to improve consumer safety and prevent deaths from severe allergic reactions.

The Centre for Food & Allergy Research (CFAR), based at the Murdoch Children's Research Institute, will expand to become the National Allergy Centre of Excellence (NACE).

The Centre will generate and synthesise the evidence base that underpins the activities of the proposed National Allergy Council (NAC), to ensure that Australia remains at the forefront of evidence-based management of allergic disease.

Associate Professor Kirsten Perrett said, "The establishment of the National Allergy Centre of Excellence will be a huge leap forward for our understanding of allergies, especially in an Australian context, and will provide a solid evidence-base for initiatives of the National Allergy Council.

"Together, we will implement the first national allergy registry alongside a live anaphylaxis reporting system, which will facilitate precision medicine and improve consumer safety and prevent anaphylaxis deaths."

The second organization is the National Allergy Council (NAC), a natural progression of the highly valued and successful National Allergy Strategy.

The Council will continue to be a partnership between the Australasian Society of Clinical Immunology and Allergy (ASCIA) and Allergy & Anaphylaxis Australia (A&AA), Australia's lead medical and allergy patient support organisations.

Together, the two organisations (NAC and NACE) will be established with S26.9 million in funding over four years.

Dr Preeti Joshi, ASCIA Co-chair of the National Allergy Strategy and representative of the peak clinical body, the Australasian society of clinical immunology and allergy (ASCIA) said the funding would allow urgent projects to progress.

"We would like to thank the Australian Government, and Minister Hunt in particular, for investing in the health and wellbeing of the many Australians living with allergic diseases. We would also like to acknowledge the leadership of the Hon Trent Zimmerman and the committee who led the Parliamentary Inquiry into Allergies and Anaphylaxis. We are also grateful to Dr Katie Allen, Member for Higgins, for her ongoing advocacy and support," Dr Joshi said.

Following specific recommendations to the Parliament's "Walking the Allergy Tightrope" report from May 2020, the National Allergy Centre of Excellence will form a National Allergy Clinical Trials network to develop and implement national large-scale adaptive platform allergy trials, embedded in routine clinical care across Australia.

These innovative trials would accelerate access to allergy treatments in Australia, and ensure efficient, head-to-head comparisons of emerging treatments (with no placebo arm) with fewer participants, less time and a greater probability of success. Protocols would be specifically tailored to participants' age and type of allergy.

These platform trials, already in place for cancer treatment, would allow futile allergy treatments to be dropped and new treatments to be added as they become available.

This will ensure that every Australian with allergy is offered the best available treatment and that clinical care guidelines are continuously updated with the latest evidence.

The National Allergy Centre of Excellence will also establish a National Allergy Registry and Biobank, including health care use, phenotypic data and biological samples from children and adults with food, drug, vaccine, pollen and insect allergy.

The National Allergy Registry and Biobank will act as a clinical quality registry, a platform for paradigm-shifting in understanding and managing allergic diseases and present new opportunities for health care practice, research and discovery.

Allergy facts

• Allergic diseases are among the fastest-growing chronic conditions in Australia, affecting approximately 1 in 5 Australians

• Delayed access to medical care and long waiting times for management of allergic diseases in all areas (rural, remote and metropolitan) is a major problem, due to the high number of diagnosed patients, newly diagnosed patients and low number of appropriately trained health care professionals

• One in 10 infants now have a food allergy and 1 in 20 children aged 10-14 years of age have a food allergy and 2-4 per cent of adults

• Food allergy induced anaphylaxis has doubled between 2003 and 2013

• Annual food anaphylaxis admission rates increased nine-fold between 1998/99 and 2018/19, the highest absolute rates in those aged less than 1 year. However, the annual rate of increase slowed in those aged 1-4 years and 5-9 years after changes to ASCIA infant feeding guidelines and in those aged 10-14 years, supporting the 'Nip allergies in the Bub' allergy prevention project

• Deaths from anaphylaxis in Australia have increased by 7 per cent per year (1997-2013)

• Those at risk of anaphylaxis live with the very real daily fear of a life-threatening severe allergic reaction. Individuals at risk of food allergy induced anaphylaxis and their carers have higher than average rates of anxiety

• Fatalities from food-induced anaphylaxis increase by around 10 per cent each year

• Self-reported antibiotic allergy is common in Australian patients. The overall self-reported antibiotic allergy rate for all hospital patients is 18% for adults (10,11) and 24 per cent reported for general medical inpatients in a multi-centre study in Victoria

• Importantly, 90 per cent of patients with an unconfirmed antibiotic allergy label are not allergic and can safely tolerate the antibiotic after undergoing validated drug allergy assessment. This over labelling results in inappropriate prescribing and increased use of broad-spectrum antimicrobials, poor patient outcomes and a financial impact on the health system