Impact and Oral Immunotherapy on Quality of Life in Children with Cow Milk Allergy: A Pilot Study

Carraro, Silvia; Frigo, Annachiara; Perin, M.; Stefani, Stefano S.; Cardarelli, C; Bozzetto, Sara; Baraldi, E; Zanconato, Stefania

doi:10.1177/039463201202500329

Cited by 58 publications

(54 citation statements)

References 13 publications

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“…Oral immunotherapy is a promising therapy for FA. Studies in patients and parents have demonstrated a general positive effect of OIT on some aspects of QoL, especially food anxiety and social and dietary limitation but not emotional impact . Certain characteristics seem to be associated with greater improvements in caregiver QoL: in a prospective randomized study, QoL improved more in caregivers of participants older than 10 years or desensitized to more than 4 food allergens than those who were not …”

Section: Results From the Selected Literaturementioning

confidence: 99%

Anxiety and food allergy: A review of the last two decades

Polloni

Muraro

2020

Clin Experimental Allergy

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Food allergy (FA) is recognized as a growing public health burden affecting 5%‐10% of children worldwide. Several unique features specific to FA elicit high levels of emotional distress and anxiety in patients and caregivers, the first among all the possibility of a life‐threatening reaction. Anxiety disorders are highly prevalent in patients with chronic disease, but remain undertreated despite significant negative consequences on patient health. This review aimed to offer a comprehensive overview of literature data on FA and anxiety of the last two decades. A review of the medical and psychological literature from the year 2000 (MEDLINE, PubMed and PsycINFO) was done using the keywords “anxiety” and “food allergy.” Clinical implications for disease management, various manifestations in different target groups, proper interventions and possible explanations on the nature of the association between FA and anxiety have been discussed, as well as limitations and further research directions. The relationship between FA and anxiety is attributed to FA‐specific fears and anxiety, rather than a general propensity towards anxiety. Some anxiety—short‐lived and related to key events–is to be expected and may even be helpful if it sustains allergen avoidance and preparedness to emergency. However, some data reported that increased anxiety did not improve adherence. Rather, high levels of anxiety have been demonstrated counterproductive and related to maladaptive coping. Further research is needed to elucidate the association between FA and anxiety, especially to understand biopsychosocial directions of the underlying mechanisms and to build proper, effective, standardized protocols of intervention. Clinicians must be aware of the association between FA and anxiety, understand their role in recognizing maladaptive anxiety and encouraging to seek psychological support when needed.

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Section: Results From the Selected Literaturementioning

confidence: 99%

Anxiety and food allergy: A review of the last two decades

Polloni

Muraro

2020

Clin Experimental Allergy

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“…This raises the question as to whether reactions with dosing outweigh the benefit gained from therapy, which can only be addressed by an objective evaluation of quality of life influenced specifically by health and disease, or health-related quality of life (HRQL) [14-16]. While single-allergen OIT has been found to result in HRQL improvement in participants with peanut or cow milk allergy [17,18], this study is the first to investigate the effects of mOIT and of rush mOIT with omalizumab on FA-related HRQL.…”

Section: Introductionmentioning

confidence: 99%

Multiple-allergen oral immunotherapy improves quality of life in caregivers of food-allergic pediatric subjects

Otani

Bégin

Kearney

et al. 2014

All Asth Clin Immun

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BackgroundFood allergy (FA) negatively affects quality of life in caregivers of food-allergic children, imposing a psychosocial and economic burden. Oral immunotherapy (OIT) is a promising investigational therapy for FA. However, OIT can be a source of anxiety as it carries risk for allergic reactions. The effect of OIT with multiple food allergens (mOIT) on FA-specific health-related quality of life (HRQL) has never been studied in participants with multiple, severe food allergies. This study is the first to investigate the effects of mOIT on FA-related HRQL in caregivers of pediatric subjects.MethodsCaregiver HRQL was assessed using a validated Food Allergy Quality of Life – Parental Burden (FAQL-PB) Questionnaire (J Allergy Clin Immunol 114(5):1159-1163, 2004). Parents of participants in two single-center Phase I clinical trials receiving mOIT (n = 29) or rush mOIT with anti-IgE (omalizumab) pre-treatment (n = 11) completed the FAQL-PB prior to study intervention and at 2 follow-up time-points (6 months and 18 months). Parents of subjects not receiving OIT (control group, n = 10) completed the FAQL-PB for the same time-points.ResultsHRQL improved with clinical (change < -0.5) and statistical (p < 0.05) significance in the mOIT group (baseline mean 3.9, 95% CI 3.4-4.4; 6-month follow-up mean 2.5, 95% CI 2.0-3.0; 18-month follow-up mean 1.8, 95% CI 1.4-2.1) and rush mOIT group (baseline mean 3.9, 95% CI 3.1-4.7; 6-month follow-up mean 1.7, 95% CI 0.9-2.6; 18-month follow-up mean 1.3, 95% CI 0.3-2.4). HRQL scores did not significantly change in the control group (n = 10).ConclusionMulti-allergen OIT with or without omalizumab leads to improvement in caregiver HRQL, suggesting that mOIT can help relieve the psychosocial and economic burden FA imposes on caregivers of food-allergic children.

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“…Patients with a positive result to an OFC for heated cow's milk can poorly tolerate cow's milk in any form 3. Patients were forced to accept the elimination of cow's milk from their diet, thereby decreasing their QOL.…”

Section: Discussionmentioning

confidence: 99%

Butter Tolerance in Children Allergic to Cow's Milk

Yanagida

Minoura

Kitaoka

2015

Allergy Asthma Immunol Res

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We performed an oral food challenge (OFC) with 10 g of butter (equivalent of 2.9 mL cow's milk) and 25-mL heated cow's milk for 68 children with cow's milk-allergy. Thirty-eight children reacted only to heated cow's milk. Twenty-four children reacted to neither heated milk nor butter. Thirty-eight (86.4%) of 44 patients with positive results to the OFC for heated milk could safely tolerate butter. It is highly likely that even children with cow's milk-allergy who show positive results to an OFC for heated milk can consume butter. The milk-specific IgE value indicative of a negative predictive value of over 95% was 17.8 kUA/L, and patients with low milk-specific IgE values may be able to safely consume butter. Including butter in the diets of patients with milk-allergy after a butter challenge may improve quality of life.

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Impact and Oral Immunotherapy on Quality of Life in Children with Cow Milk Allergy: A Pilot Study

Cited by 58 publications

References 13 publications

Anxiety and food allergy: A review of the last two decades

Anxiety and food allergy: A review of the last two decades

Multiple-allergen oral immunotherapy improves quality of life in caregivers of food-allergic pediatric subjects

Butter Tolerance in Children Allergic to Cow's Milk

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