BACKGROUND: Limited published evidence shows oral desensitization to be a potential intervention option for cow's milk protein (CMPs) allergy. OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of oral desensitization in 2-year-old children with cow's milk allergy, as a treatment alternative to elimination diet. METHODS: A total of 60 children aged 24-36 months with IgE-mediated allergy to CMPs were included in this multi-center study and were randomized into two groups. Thirty children (group A: treatment group) beganoral desensitization immediately, whereas the remaining 30 (group B: control group) were kept on a milk-free diet and followed-up for 1 year. RESULTS: After 1-year follow-up period, 90% of the children in group A had become completely tolerant vs. 23% of the children in group B. In group A, cow's milk skin reactivity and serum-specific IgE to milk and casein decreased significantly from the initial assessment, whereas group B showed no significant change after 1 year of follow-up. Twenty-four patients (80%) developed some reaction during the treatment period: 14 children developed moderate reaction (47%) and 10 mild reaction (33%). The most common manifestations were urticaria-angioedema, followed by cough. CONCLUSIONS AND CLINICAL RELEVANCE: In this study, oral desensitization was found to be effective in a significant percentage of 2-year-old children with cow's milk allergy. Oral desensitization appears to be efficacious as an alternative to elimination diet in the treatment of 2-year-old children with cow's milk allergy. The side-effect profile appears acceptable but requires further study.
RCT Entities:
BACKGROUND: Limited published evidence shows oral desensitization to be a potential intervention option for cow's milk protein (CMPs) allergy. OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of oral desensitization in 2-year-old children with cow's milk allergy, as a treatment alternative to elimination diet. METHODS: A total of 60 children aged 24-36 months with IgE-mediated allergy to CMPs were included in this multi-center study and were randomized into two groups. Thirty children (group A: treatment group) began oral desensitization immediately, whereas the remaining 30 (group B: control group) were kept on a milk-free diet and followed-up for 1 year. RESULTS: After 1-year follow-up period, 90% of the children in group A had become completely tolerant vs. 23% of the children in group B. In group A, cow's milk skin reactivity and serum-specific IgE to milk and casein decreased significantly from the initial assessment, whereas group B showed no significant change after 1 year of follow-up. Twenty-four patients (80%) developed some reaction during the treatment period: 14 children developed moderate reaction (47%) and 10 mild reaction (33%). The most common manifestations were urticaria-angioedema, followed by cough. CONCLUSIONS AND CLINICAL RELEVANCE: In this study, oral desensitization was found to be effective in a significant percentage of 2-year-old children with cow's milk allergy. Oral desensitization appears to be efficacious as an alternative to elimination diet in the treatment of 2-year-old children with cow's milk allergy. The side-effect profile appears acceptable but requires further study.
Authors: Julie Wang; Stacie M Jones; Jacqueline A Pongracic; Ying Song; Nan Yang; Scott H Sicherer; Melanie M Makhija; Rachel G Robison; Erin Moshier; James Godbold; Hugh A Sampson; Xiu-Min Li Journal: J Allergy Clin Immunol Date: 2015-06-01 Impact factor: 10.793
Authors: Stacie M Jones; A Wesley Burks; Corinne Keet; Brian P Vickery; Amy M Scurlock; Robert A Wood; Andrew H Liu; Scott H Sicherer; Alice K Henning; Robert W Lindblad; Peter Dawson; Cecilia Berin; David M Fleischer; Donald Y M Leung; Marshall Plaut; Hugh A Sampson Journal: J Allergy Clin Immunol Date: 2016-03-09 Impact factor: 10.793
Authors: Emma M Savilahti; Mikael Kuitunen; Miko Valori; Ville Rantanen; Ludmilla Bardina; Gustavo Gimenez; Mika J Mäkelä; Sampsa Hautaniemi; Erkki Savilahti; Hugh A Sampson Journal: Pediatr Allergy Immunol Date: 2014-01-06 Impact factor: 6.377