Oral immunotherapy for food allergy: A Spanish guideline. Egg and milk immunotherapy Spanish guide (ITEMS GUIDE). Part 2: Maintenance phase of cow milk (CM) and egg oral immunotherapy (OIT), special treatment dosing schedules. Models of dosing schedules of OIT with CM and EGG

Martorell, A.; Alonso, E.; Echeverría, Luis; Escudero, Carmelo; García-Rodríguez, R.; Blasco, Cristina; Bone, J. M.; Borja-Segade, J; Bracamonte, Teresa; Claver, Angela; Corzo, JL; Hoz, B de la; Olmo, R. del; Domínguez, Olga; Fuentes‐Aparicio, Victoria; Guallar, I.; Larramona, H.; Martín-Muñoz, F; Matheu, Víctor; Michavila, A.; Ojeda, I; Ojeda, Pedro; Piquer, M.; Poza, Paloma; Reche, Marta; Río, Pablo Rodríguez del; Rodríguez, María Luisa Sancho; Pérez, Francisco Javier Ruano; Sánchez‐García, Silvia; Terrados, S.; Valdesoiro, Laura; Vazquez‐Ortiz, Marta

doi:10.1016/j.aller.2017.05.002

Cited by 14 publications

(20 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Almost all protocols of CM-OIT recommend administering daily doses during the maintenance phase. There is no strong evidence to recommend less frequent dosing, since a lesser frequency of exposure may result in losing the desensitization effect [ 21 ]. No differences in the occurrence of allergic reactions were observed comparing protocol schedules involving daily doses to twice weekly doses [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Cow’s milk oral immunotherapy in real life: 8-year long-term follow-up study

Mota

Piedade

Gáspár

et al. 2018

Asia Pacific Allergy

View full text Add to dashboard Cite

BackgroundOral immunotherapy (OIT) has been recognized as a promising treatment for severe and long-lasting cow's milk (CM) allergy. Once maintenance has been achieved, patients should maintain daily intake of CM to ensure desensitization. Clinical experience concerning long-term follow-up is scarce.ObjectiveThe authors aimed to assess long-term efficacy and safety of a maintenance phase of OIT in real life.MethodsProspective study of all children and adolescents, who underwent CM-OIT and were subsequently followed at our allergy center on maintenance dose (200 mL daily) for at least 36 months after reaching the maintenance phase (from 2009 to 2016).ResultsForty-two patients were enrolled: 60% male, 36% with history of anaphylaxis and 57% with asthma. The median time of follow-up was 69 months (range, 39–105 months) and the median age at the last clinical evaluation was 13 years (range, 6–23 years). Regarding adherence to the protocol: 92% are on free diet (at least 200 mL of CM daily; 7-g protein); 14% had transient interruptions and 7% definitely withdrawn with loss of tolerance. During maintenance, 45% developed mild to severe allergic reactions, and 7% had more than 3 episodes. A positive correlation between the occurrence of allergic reactions and history of anaphylaxis (p < 0.001) was found. The coexistence of asthma was risk factor for the occurrence of allergic reactions during maintenance.ConclusionThis real-life study supports long-term efficacy and safety of CM-OIT. Despite daily intake, 41% had symptoms at some moment during the complete follow-up period; a total of 33 symptomatic days in patients with mean follow-up time of 67.5 months. Clinical tolerance depends on daily intake. The protective effect reached can be lost after CM withdrawal. History of anaphylaxis was a risk factor for the occurrence of allergic reactions during the maintenance phase.

show abstract

Section: Discussionmentioning

confidence: 99%

Cow’s milk oral immunotherapy in real life: 8-year long-term follow-up study

Mota

Piedade

Gáspár

et al. 2018

Asia Pacific Allergy

View full text Add to dashboard Cite

show abstract

“…Thus, the pattern of cytokines in peripheral blood does not seem to differ between these populations, with the result that its determination at the beginning of OIT cannot predict the need for more cautious administration in specific patients. Other analytical parameters, such as specific IgE values, wheal diameter, and basophil activation can predict which patients have a greater risk of developing anaphylaxis during OIT [4,5,8].…”

Section: Resultsmentioning

confidence: 99%

“…OIT with egg consisted of the administration of incremental doses of dehydrated egg whites (OVO DES NM, Nutrición Médica) in 9 steps or milk according to the protocol of SEICAP [4,5]. The egg could be administered in water or orange juice.…”

Section: In Vivo Testsmentioning

confidence: 99%

See 1 more Smart Citation

Oral Immunotherapy With Egg and Milk: Changes in Peripheral Serum Cytokines Are Not Predictive Factors for Severe Adverse Reactions or for the Final Report

García-Lirio¹,

Díaz²,

Hermosa³

et al. 2018

J Investig Allergol Clin Immunol

View full text Add to dashboard Cite

Introduction: Oral immunotherapy (OIT) is a new approach in patients with food allergy. Various immunological mechanisms underlie the reversal of food allergy. In this paper, we study possible changes in peripheral cytokine patterns during OIT. Methods: Determinations of cytokines in peripheral blood were made in children who had milk or egg allergy and who received OIT. The determinations were made before and after OIT, and again following a final repeat oral challenge a month after a diet excluding the culprit food. Results: No significant changes were registered in the cytokines studied (IL-2, IL-4, IL-6, IL-10, IL-12, IL-17, IFNγ, and TNF) at any of the 3 time points. Similarly, no differences in cytokine pattern were observed between children who had presented anaphylaxis during OIT and those who overcame or did not overcome the final oral challenge. Discussion: Peripheral cytokines do not undergo significant changes during the OIT process. They are not predictors of serious adverse reactions or the final result of the OIT.

show abstract

“…As sensitization profiles vary from patient to patient, we do not know whether patients sensitized to proteins such as cocosin would respond in the same way. Data on desensitization to milk and egg suggest that high titers of specific IgE against casein and ovomucoid correlate with a poorer outcome of desensitization [9]. A similar phenomenon may occur with coconut and other foods.…”

mentioning

confidence: 95%