Successful oral desensitization in children with cow's milk anaphylaxis: Clinical and laboratory evaluation up to nine-years follow-up

Alves‐Correia, Magna; Gáspár, Angéla; Borrego, Luís Miguel; Azevedo, J. L.; Martins, Catarina; Morais‐Almeida, Mário

doi:10.1016/j.aller.2018.07.007

Cited by 7 publications

(15 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Maintenance therapy upon discontinuation of AIT may be used in order to prolong the achieved tolerance in patients with FA, but the maintenance doses vary greatly. Along with DBPCFC, SPT may be used to test the induced tolerance in patients undergoing OIT (53,(70)(71)(72).…”

Section: Skin Prick Testmentioning

confidence: 99%

Immunological Outcomes of Allergen-Specific Immunotherapy in Food Allergy

et al. 2020

View full text Add to dashboard Cite

Section: Skin Prick Testmentioning

confidence: 99%

Immunological Outcomes of Allergen-Specific Immunotherapy in Food Allergy

et al. 2020

View full text Add to dashboard Cite

“…3 Greater understanding of the immune pathogenesis of CMA has been accompanied by a shift in dietary management of CMA from simple elimination diets to more active interventions designed to modulate the immune system and improve the development of tolerance. [7][8][9][10][11][12] Limited data from clinical studies in formula-fed infants implied better symptom resolution 13 but slower tolerance development with amino acid-based formula (AAF) than extensively hydrolyzed formula (eHF). 14 Gut microbiota can influence the development of immune responses and food allergies during early infancy.…”

mentioning

confidence: 99%

Tolerance development in cow’s milk–allergic infants receiving amino acid–based formula: A randomized controlled trial

Chatchatee

Nowak‐Węgrzyn

Lange

et al. 2022

Journal of Allergy and Clinical Immunology

View full text Add to dashboard Cite

Regeneron; serves the American College of Allergy, Asthma, and Immunology as deputy editor of the Annals of Allergy, Asthma, and Immunology and is a member of the American Board of Allergy and Immunology outside the submitted work; and is on the medical advisory board (unpaid) of the International FPIES Association. L. Lange Background: Tolerance development is an important clinical outcome for infants with cow's milk allergy. Objective: This multicenter, prospective, randomized, doubleblind, controlled clinical study (NTR3725) evaluated tolerance development to cow's milk (CM) and safety of an amino acidbased formula (AAF) including synbiotics (AAF-S) comprising prebiotic oligosaccharides (oligofructose, inulin) and probiotic Bifidobacterium breve M-16V in infants with confirmed IgEmediated CM allergy. Methods: Subjects aged < _13 months with IgE-mediated CM allergy were randomized to receive AAF-S (n 5 80) or AAF (n 5 89) for 12 months. Stratification was based on CM skin prick test wheal size and study site. After 12 and 24 months, CM tolerance was evaluated by double-blind, placebo-controlled food challenge. A logistic regression model used the all-subjects randomized data set. Results: At baseline, mean 6 SD age was 9.36 6 2.53 months. At 12 and 24 months, respectively, 49% and 62% of subjects were CM tolerant (AAF-S 45% and 64%; AAF 52% and 59%), and not differ significantly between groups. During the 12-month intervention, the number of subjects reporting at least 1 adverse event did not significantly differ between groups; however, fewer subjects required hospitalization due to serious adverse events categorized as infections in the AAF-S versus AAF group (9% vs 20%; P 5 .036). Conclusions: After 12 and 24 months, CM tolerance was not different between groups and was in line with natural outgrowth. Results suggest that during the intervention, fewer subjects receiving AAF-S required hospitalization due to infections. (J Allergy Clin Immunol 2021;nnn:nnn-nnn.)

show abstract

“…If the sustained unresponsiveness is to be evaluated, the patient avoids CM for a time period (generally 2-8 weeks) and then a new oral food challenge (OFC) is performed ( 14 ). Recently, the safety and efficacy results of long-term milk oral immunotherapy were investigated ( 15 , 16 ). In this study, we aimed to present our experience of oral immunotherapy for Cow’s milk allergy at a pediatric allergy outpatient clinic, to evaluate risk factors for the development of its adverse reactions, and to demonstrate its long-term effectiveness.…”

mentioning

confidence: 99%

Oral Immunotherapy with Cow's Milk Allergy: Five Years' Experience from a Single Center in Turkey

et al. 2020

View full text Add to dashboard Cite

Background: Oral immunotherapy for cow’s milk allergy is an effective treatment option because of its ability to increase the threshold for clinical reactions. Aims: To present our experience of oral immunotherapy for cow’s milk allergy in the pediatric allergy outpatient clinic, and to evaluate the long-term efficacy of oral immunotherapy and risk factors for adverse reactions during oral immunotherapy. Study Design: Single-center retrospective cohort study. Methods: Forty-two patients with Immunoglobulin-E-mediated cow’s milk allergy who complied with the oral immunotherapy protocol were evaluated in this study. The treatment consisted of a rapid escalation phase with an oral food challenge step that included milk doses. During the build-up phase, increasing quantities of cow’s milk were administered until the patient was able to consume 200 mL of cow’s milk daily. Results: The mean age of starting the oral immunotherapy was 40.2±3.2 (range, 36-156) months, and 54.8% (n=23) of the patients were males. The mean duration of the build-up phase was 18.1±5.6 (range, 9-41) weeks, and the mean maintenance phase was 29.1±11.6 (range, 12-63) months. During the oral immunotherapy, 36 adverse reactions (78% mild and 22% moderate) occurred in 16 (38%) patients. There were no differences in the age of starting the oral immunotherapy (p=0.19), cow’s milk-specific Immunoglobulin-E levels (p=0.17), and cumulative provocative doses of oral food challenges (p=0.78) between the two groups of patients with and without adverse reactions. The wheal diameters to cow’s milk were higher in the group with adverse reactions (p=0.03). There was no difference in the oral immunotherapy onset age between patients with and without a history of anaphylaxis (p=0.38). The patients with a history of anaphylaxis had more adverse reactions (p=0.04) and a higher number of reactions during the oral immunotherapy (p=0.01), and a higher mean duration of the up-dosing phase (p=0.04) compared with patients without anaphylaxis. Conclusion: Oral immunotherapy is a treatment option in patients with cow’s milk allergy because of its high efficacy. Adverse reactions occur in about 40% of cases and are mostly mild. It should be administered with caution to patients with a history of anaphylaxis and a higher wheal diameter to cow’s milk in the skin prick test.

show abstract

Successful oral desensitization in children with cow's milk anaphylaxis: Clinical and laboratory evaluation up to nine-years follow-up

Cited by 7 publications

References 28 publications

Immunological Outcomes of Allergen-Specific Immunotherapy in Food Allergy

Immunological Outcomes of Allergen-Specific Immunotherapy in Food Allergy

Tolerance development in cow’s milk–allergic infants receiving amino acid–based formula: A randomized controlled trial

Oral Immunotherapy with Cow's Milk Allergy: Five Years' Experience from a Single Center in Turkey

Contact Info

Product

Resources

About