Goals and motivations of families pursuing oral immunotherapy for food allergy

Dunlop, Joan H.; Keet, Corinne A.

doi:10.1016/j.jaip.2018.05.035

Cited by 29 publications

(15 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While parents have a broader perspective and may carry the burden of the child's past medical history, children, on the other hand, are influenced by the evolving present. Therefore, while parental anxiety may be alleviated by the active initiative taken by starting OIT, and by the extensive information and the availability of expert support during treatment, 7,29,30 children need a child‐oriented approach.…”

Section: Discussionmentioning

confidence: 99%

Medical clown support is associated with better quality of life of children with food allergy starting oral immunotherapy

Epstein‐Rigbi

Schwartz

Goldberg

et al. 2021

Pediatric Allergy Immunology

View full text Add to dashboard Cite

Background The start of oral immunotherapy (OIT) for food allergy is a critical period in the treatment process, with a potential to influence patient quality of life (QOL) and subsequently treatment outcome. The association of medical clowning with QOL at OIT initiation was examined. Methods Children aged 4‐12 years supported by a medical clown (MC) during the induction week of OIT for food allergy were studied. Children in the same age range starting OIT without the support of a MC served as controls. Parents of all children completed the Food Allergy Quality of Life Questionnaire—Parent Form (FAQLQ‐PF), and children aged 8‐12 years completed the Food Allergy Quality of Life Questionnaire—Child Form (FAQLQ‐CF). QOL scores of parents and children with and without a MC support were compared. Results Children with (n = 88) and without (n = 212) the support of a MC were comparable in demographics and clinical characteristics. The study group had a significantly lower single highest tolerated dose compared to controls (57 ± 83 vs 162 ± 274 mg protein, respectively, P < .001). Parental perception of the QOL of children was not associated with a MC support (P = .81) but rather with previous reaction severity (P < .01). In contrast, the QOL of children aged 8‐12 years (n = 119) was positively associated primarily with a MC support, total score 3.7 ± 1.1 vs 4.6 ± 1.3 (P < .001). Conclusions While the perception of QOL of parents of children with food allergy at OIT initiation is mainly associated with previous reaction severity, the QOL of the children themselves is primarily positively associated with MC support.

show abstract

Section: Discussionmentioning

confidence: 99%

Medical clown support is associated with better quality of life of children with food allergy starting oral immunotherapy

Epstein‐Rigbi

Schwartz

Goldberg

et al. 2021

Pediatric Allergy Immunology

View full text Add to dashboard Cite

show abstract

“…• may include developing a buffer against reactions due to accidental exposure, 155 translating to increased sense of freedom in daily life, 156 ability to freely eat the food allergen, 155 157 to consume a limited amount of the food allergen with caution, 155 or to reduce the risk of a fatal food reaction. 157 Page 34 of 45 Bégin et al Allergy Asthma Clin Immunol (2020) 16:20…”

Section: C11-acceptability and Capacity To Empower Users And Caregivementioning

confidence: 99%

CSACI guidelines for the ethical, evidence-based and patient-oriented clinical practice of oral immunotherapy in IgE-mediated food allergy

Bégin

Chan

Kim

et al. 2020

Allergy Asthma Clin Immunol

124

118

View full text Add to dashboard Cite

Background: Oral immunotherapy (OIT) is an emerging approach to the treatment of patients with IgE-mediated food allergy and is in the process of transitioning to clinical practice.Objective: To develop patient-oriented clinical practice guidelines on oral immunotherapy based on evidence and ethical imperatives for the provision of safe and efficient food allergy management. Materials and methods:Recommendations were developed using a reflective patient-centered multicriteria approach including 22 criteria organized in five dimensions (clinical, populational, economic, organizational and sociopolitical). Data was obtained from: (1) a review of scientific and ethic literature; (2) consultations of allergists, other healthcare professionals (pediatricians, family physicians, nurses, registered dieticians, psychologists, peer supporters), patients and caregivers; and patient associations through structured consultative panels, interviews and on-line questionnaire; and (3) organizational and economic data from the milieu of care. All data was synthesized by criteria in a multicriteria deliberative guide that served as a platform for structured discussion and development of recommendations for each dimension, based on evidence, ethical imperatives and other considerations. Results:The deliberative grid included 162 articles from the literature and media reviews and data from consultations involving 85 individuals. Thirty-eight (38) recommendations were made for the practice of oral immunotherapy for the treatment of IgE mediated food allergy, based on evidence and a diversity of ethical imperatives. All recommendations were aimed at fostering a context conducive to achieving objectives identified by patients and caregivers with food allergy. Notably, specific recommendations were developed to promote a culture of shared responsibility between patients and healthcare system, equity in access, patient empowerment, shared decision making and personalization of OIT protocols to reflect patients' needs. It also provides recommendations to optimize organization of care to generate capacity to meet demand according to patient choice, e.g. OIT or avoidance. These recommendations were made acknowledging the necessity of ensuring sustainability of the clinical offer in light of various economic considerations. © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article' s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article'A multidisciplinary team comprised of experts from a diversity of fields was assembled, including allergists and other healthcare professional...

show abstract

“…Almond, cod, salmon, shrimp, and soy plasma markers not shown due to small sample size questions. Many parents have a desire for protection against severe reactions from accidental ingestions 38,39 and not necessarily to routinely consume the food ad lib. In our experience, many families have turned down clinical trials at the prospect of OFCs.…”

Section: Discussionmentioning

confidence: 99%

Phase 2, randomized multi oral immunotherapy with omalizumab ‘real life’ study

Sindher

Kumar

Cao

et al. 2022

Allergy

View full text Add to dashboard Cite

Background: Oral immunotherapy (OIT) is frequently discontinued due to adverse events (AEs) and current data suggests that lowering OIT doses can minimize severity and frequency of AEs. However, the minimum daily dose that can enable desensitization and induce immune responses in multi-food OIT (mOIT) is unknown.Methods: Participants aged 2-25 years with multi-food allergies were pretreated with fixed-dose omalizumab (150 mg, 3 doses, every 4 weeks), and randomized 1:1 to receive mOIT to a total maintenance dose of either 300 or 1200 mg total protein, (total dose includes at least two and up to a max of five allergens) and then transitioned to real-food protein equivalents after 18 weeks of treatment. The primary endpoint was the proportion of subjects with increases in IgG4/IgE ratio of at least 2 allergens by ≥25% from baseline after 18 weeks of therapy. The primary efficacy and safety analyses were done in the intention-to-treat population.Results: Sixty participants were enrolled across two sites. Seventy percent of participants in both arms showed changes in sIgG4/sIgE ratio in at least 2 allergens with no difference between the treatment groups (OR [95% CI] = 1.00 [0.29, 3.49]). Overall, there were no differences in AEs between the 300 and 1200 mg groups (19% vs. 17%, p = .69), respectively. Conclusions:Our data suggest that plasma marker changes are induced early, even at a total protein dose of 300 mg inclusive of multiple allergens when mOIT is combined with fixed-dose omalizumab. Identification of optimal mOIT dosing with adjunct omalizumab is needed for the long-term success of OIT.

show abstract

Goals and motivations of families pursuing oral immunotherapy for food allergy

Cited by 29 publications

References 6 publications

Medical clown support is associated with better quality of life of children with food allergy starting oral immunotherapy

Medical clown support is associated with better quality of life of children with food allergy starting oral immunotherapy

CSACI guidelines for the ethical, evidence-based and patient-oriented clinical practice of oral immunotherapy in IgE-mediated food allergy

Phase 2, randomized multi oral immunotherapy with omalizumab ‘real life’ study

Contact Info

Product

Resources

About