Long-term adherence and risk of allergic reactions in patients who attained milk oral immunotherapy maintenance.

Food allergy management allergic reaction anaphylaxis maintenance dose maintenance phase milk allergy oral immunotherapy protocol adherence unresponsiveness

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:
27 Jun 2024
Historique:
received: 30 06 2023
revised: 27 05 2024
accepted: 18 06 2024
medline: 30 6 2024
pubmed: 30 6 2024
entrez: 29 6 2024
Statut: aheadofprint

Résumé

Oral immunotherapy (OIT) has emerged as the most popular therapy for food allergy. However, data on the long-term adherence and efficacy of this approach are sparse. We aimed to assess the long-term adherence rates to OIT protocol and the associated risk of allergic reactions. Patients who completed milk OIT and reached a maintenance dose of 200 ml of milk were surveyed biannually on their dairy consumption and occurrence of allergic reactions. A survival analysis was performed to evaluate the association between the risk of reaction and adherence to OIT maintenance protocol. The cohort consisted of 50 patients. Only 56% of the cohort adhered to protocol, which consisted of ingesting a minimum of 200 ml of milk at least 3 times per week. Adherent patients had a significantly reduced risk of allergic reactions, as well as a reduced incidence of anaphylaxis, healthcare/ER visits, and epinephrine/antihistamine administration. The findings demonstrate the importance of consistent maintenance dose consumption in the management of food allergies, with regular milk consumption contributing to the maintenance of unresponsiveness and decreased risk of allergic symptoms.

Sections du résumé

BACKGROUND BACKGROUND
Oral immunotherapy (OIT) has emerged as the most popular therapy for food allergy. However, data on the long-term adherence and efficacy of this approach are sparse.
OBJECTIVE OBJECTIVE
We aimed to assess the long-term adherence rates to OIT protocol and the associated risk of allergic reactions.
METHODS METHODS
Patients who completed milk OIT and reached a maintenance dose of 200 ml of milk were surveyed biannually on their dairy consumption and occurrence of allergic reactions. A survival analysis was performed to evaluate the association between the risk of reaction and adherence to OIT maintenance protocol.
RESULTS RESULTS
The cohort consisted of 50 patients. Only 56% of the cohort adhered to protocol, which consisted of ingesting a minimum of 200 ml of milk at least 3 times per week. Adherent patients had a significantly reduced risk of allergic reactions, as well as a reduced incidence of anaphylaxis, healthcare/ER visits, and epinephrine/antihistamine administration.
CONCLUSION CONCLUSIONS
The findings demonstrate the importance of consistent maintenance dose consumption in the management of food allergies, with regular milk consumption contributing to the maintenance of unresponsiveness and decreased risk of allergic symptoms.

Identifiants

DOI: 10.1016/j.jaip.2024.06.031 PMID: 38944196
pubmed: 38944196
pii: S2213-2198(24)00668-8
doi: 10.1016/j.jaip.2024.06.031
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Pasquale Mulé (P)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: pasquale.mule2@mail.mcgill.ca.

Xun Zhang (X)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: xun.zhang@mail.mcgill.ca.

Connor Prosty (C)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: connor.prosty@mail.mcgill.ca.

Liane Beaudette (L)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: liane.beaudette@muhc.mcgill.ca.

Casey G Cohen (CG)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: casey.cohen2@mail.mcgill.ca.

Edmond Chan (E)

Division of Allergy and Immunology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: echan5@cw.bc.ca.

Ann Elaine Clarke (AE)

Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: aeclarke@ucalgary.ca.

Eyal Grunebaum (E)

Division of Immunology and Allergy, Department of Pediatrics, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON, Canada. Electronic address: eyal.grunebaum@sickkids.ca.

Danbing Ke (D)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: danbing.ke@affiliate.mcgill.ca.

Duncan Lejtenyi (D)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: duncan.lejtenyi@muhc.mcgill.ca.

Chiara Lucchesi (C)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: chiara.lucchesi@muhc.mcgill.ca.

Bruce Mazer (B)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: bruce.mazer@mcgill.ca.

Christine McCusker (C)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: christine.mccusker@mcgill.ca.

Julia Upton (J)

Division of Immunology and Allergy, Department of Pediatrics, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON, Canada. Electronic address: julia.upton@sickkids.ca.

Lydia Zhang (L)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: lydia.zhang@mcgill.ca.

Moshe Ben-Shoshan (M)

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. Electronic address: moshe.ben-shoshan@mcgill.ca.

Classifications MeSH