Quality of Life of Food-Allergic Patients Before, During, and After Oral Immunotherapy.


Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
02 2019
Historique:
received: 12 03 2018
revised: 13 05 2018
accepted: 14 06 2018
pubmed: 22 8 2018
medline: 14 7 2020
entrez: 22 8 2018
Statut: ppublish

Résumé

Oral immunotherapy (OIT) for food allergy is demanding but data on patients' quality of life (QOL) throughout the process are limited. To characterize changes in QOL of food-allergic patients during and after OIT. In a prospective cohort study, the Food Allergy Quality of Life Questionnaire-Parental Form (FAQLQ-PF) was administered to parents of 191 consecutive children aged 4 to 12 years undergoing OIT for food allergy. Questionnaires were administered at OIT initiation, mid up-dosing, upon reaching maintenance, and after 6 months of follow-up. Age- and sex-matched food-allergic children (n = 48) not undergoing OIT served as controls. FAQLQ-PF scores had significantly improved (decreased) from OIT initiation to reaching full maintenance (emotional impact [EI], 3.66-3.32, P = .001; food anxiety [FA], 3.90-3.32, P < .001; social and dietary limitation [SDL], 3.50-2.94, P < .001; and total score, 3.69-3.19, P < .001) and partial maintenance, whereas no change was noted in control patients. Worse baseline QOL, single food allergy, and a younger age predicted greater QOL improvement. Of the 85 (88.5%) patients who completed the FAQLQ-PF at mid up-dosing and for whom QOL deteriorated, a significant improvement was noted upon reaching maintenance. Additional significant improvement in QOL was observed in the 95 (88.8%) patients who completed the FAQLQ-PF 6 months after reaching maintenance (EI, 3.414-2.993, P = 0.049; FA, 3.37-2.593, P = .001; SDL, 2.989-2.264, P = .001; and total score, 3.266-2.614, P = .001). The QOL of food-allergic children improves significantly upon reaching OIT maintenance, with additional improvement 6 months later. The detrimental effect of OIT on some patients' QOL during up-dosing is reversed upon reaching maintenance.

Sections du résumé

BACKGROUND
Oral immunotherapy (OIT) for food allergy is demanding but data on patients' quality of life (QOL) throughout the process are limited.
OBJECTIVE
To characterize changes in QOL of food-allergic patients during and after OIT.
METHODS
In a prospective cohort study, the Food Allergy Quality of Life Questionnaire-Parental Form (FAQLQ-PF) was administered to parents of 191 consecutive children aged 4 to 12 years undergoing OIT for food allergy. Questionnaires were administered at OIT initiation, mid up-dosing, upon reaching maintenance, and after 6 months of follow-up. Age- and sex-matched food-allergic children (n = 48) not undergoing OIT served as controls.
RESULTS
FAQLQ-PF scores had significantly improved (decreased) from OIT initiation to reaching full maintenance (emotional impact [EI], 3.66-3.32, P = .001; food anxiety [FA], 3.90-3.32, P < .001; social and dietary limitation [SDL], 3.50-2.94, P < .001; and total score, 3.69-3.19, P < .001) and partial maintenance, whereas no change was noted in control patients. Worse baseline QOL, single food allergy, and a younger age predicted greater QOL improvement. Of the 85 (88.5%) patients who completed the FAQLQ-PF at mid up-dosing and for whom QOL deteriorated, a significant improvement was noted upon reaching maintenance. Additional significant improvement in QOL was observed in the 95 (88.8%) patients who completed the FAQLQ-PF 6 months after reaching maintenance (EI, 3.414-2.993, P = 0.049; FA, 3.37-2.593, P = .001; SDL, 2.989-2.264, P = .001; and total score, 3.266-2.614, P = .001).
CONCLUSION
The QOL of food-allergic children improves significantly upon reaching OIT maintenance, with additional improvement 6 months later. The detrimental effect of OIT on some patients' QOL during up-dosing is reversed upon reaching maintenance.

Identifiants

pubmed: 30129441
pii: S2213-2198(18)30417-3
doi: 10.1016/j.jaip.2018.06.016
pii:
doi:

Substances chimiques

Allergens 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

429-436.e2

Informations de copyright

Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Auteurs

Na'ama Epstein-Rigbi (N)

Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel. Electronic address: naamaepstein@gmail.com.

Michael R Goldberg (MR)

Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel.

Michael B Levy (MB)

Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel.

Liat Nachshon (L)

Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel.

Arnon Elizur (A)

Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel; Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

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