Effect of oral immunotherapy in children with milk allergy: The ORIMA study.
Administration, Oral
Allergens
/ administration & dosage
Animals
Child
Child, Preschool
Desensitization, Immunologic
/ adverse effects
Double-Blind Method
Female
Gene Expression Profiling
Humans
Immunoglobulin E
/ blood
Japan
Leukocytes, Mononuclear
/ immunology
Male
Milk
/ adverse effects
Milk Hypersensitivity
/ blood
Cow's milk allergy
Efficacy
Immunotherapy
Pediatric
Safety
Journal
Allergology international : official journal of the Japanese Society of Allergology
ISSN: 1440-1592
Titre abrégé: Allergol Int
Pays: England
ID NLM: 9616296
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
25
05
2020
revised:
22
09
2020
accepted:
23
09
2020
pubmed:
30
11
2020
medline:
6
11
2021
entrez:
29
11
2020
Statut:
ppublish
Résumé
This study was aimed at evaluating the efficacy and safety of oral immunotherapy (OIT) in children with severe cow's milk allergy. The subjects comprised 28 children (aged 3-12 years) with allergic symptoms that were induced by ≤ 10 mL of cow's milk in an oral food challenge test (OFC). The subjects were randomly allocated to the treatment group (n = 14) and control group (n = 14); the former received rush immunotherapy for 2 weeks, followed by a gradual increase of cow's milk volume to 100 mL for 1 year, and the latter completely eliminated cow's milk for 1 year. Both groups underwent an OFC with 100 mL of cow's milk after 1 year. The treatment group had significantly higher rates of a negative OFC [7/14 (50%) vs. 0/14 (0%), p < 0.01] compared with the control group. The cow's milk-specific IgE level significantly decreased in the treatment group (p < 0.01) but not in the control group (p = 0.63). During the study period, adrenaline was required in 6/14 patients (43%) of the treatment group and in 0/14 patients (0%) of the control group. Long follow-up data were available at the 2-year point after the study for 8 in the treatment group and 7 (87.5%) of these continued to ingest milk (>100 mL). The effect of immunotherapy was 50%, but the incidence of adverse events was not low. Further studies focusing on safety is necessary to standardize OIT for cow's milk allergy.
Sections du résumé
BACKGROUND
BACKGROUND
This study was aimed at evaluating the efficacy and safety of oral immunotherapy (OIT) in children with severe cow's milk allergy.
METHODS
METHODS
The subjects comprised 28 children (aged 3-12 years) with allergic symptoms that were induced by ≤ 10 mL of cow's milk in an oral food challenge test (OFC). The subjects were randomly allocated to the treatment group (n = 14) and control group (n = 14); the former received rush immunotherapy for 2 weeks, followed by a gradual increase of cow's milk volume to 100 mL for 1 year, and the latter completely eliminated cow's milk for 1 year. Both groups underwent an OFC with 100 mL of cow's milk after 1 year.
RESULTS
RESULTS
The treatment group had significantly higher rates of a negative OFC [7/14 (50%) vs. 0/14 (0%), p < 0.01] compared with the control group. The cow's milk-specific IgE level significantly decreased in the treatment group (p < 0.01) but not in the control group (p = 0.63). During the study period, adrenaline was required in 6/14 patients (43%) of the treatment group and in 0/14 patients (0%) of the control group. Long follow-up data were available at the 2-year point after the study for 8 in the treatment group and 7 (87.5%) of these continued to ingest milk (>100 mL).
CONCLUSIONS
CONCLUSIONS
The effect of immunotherapy was 50%, but the incidence of adverse events was not low. Further studies focusing on safety is necessary to standardize OIT for cow's milk allergy.
Identifiants
pubmed: 33248880
pii: S1323-8930(20)30138-6
doi: 10.1016/j.alit.2020.09.011
pii:
doi:
Substances chimiques
Allergens
0
Immunoglobulin E
37341-29-0
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
223-228Informations de copyright
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