International Archives of Allergy and Immunology
Clinical Allergy – Research Article
Single-Center Noninferiority Randomized Trial on the Efficacy and Safety of Low- and High-Dose Rush Oral Milk Immunotherapy for Severe Milk AllergyTakaoka Y.a · Yajima Y.b · Ito Y.M.c · Kumon J.a · Muroya T.d · Tsurinaga Y.a · Shigekawa A.a · Takahashi S.e · Iba N.f · Tsuji T.g · Nishikido T.h · Yoshida Y.a · Doi S.i · Kameda M.aaDepartment of Pediatrics, Osaka Habikino Medical Center, Habikino, Japan
bDepartment of Pediatrics, Tannan Regional Medical Center, Sabae, Japan cDepartment of Biostatics, Hokkaido University Hospital Clinical Research and Medical Innovation Center, Sapporo, Japan dDepartment of Pediatrics, Suita Municipal Hospital, Suita, Japan eDepartment of Pediatrics, Sumitomo Hospital, Osaka, Japan fDepartment of Pediatrics, Arida Municipal Hospital, Arida, Japan gDepartment of Pediatrics, Okinawa Chubu Hospital, Uruma, Japan hDepartment of Respiratory and Allergy, Osaka Women’s and Children’s Hospital, Izumi, Japan iFaculty of Education, Shitennoji University, Habikino, Japan |
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Received: February 21, 2020
Accepted: May 13, 2020
Published online: June 22, 2020
Issue release date: September 2020
Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 2
ISSN: 1018-2438 (Print)
eISSN: 1423-0097 (Online)
For additional information: https://www.karger.com/IAA
Abstract
Introduction: Oral immunotherapy (OIT) has been reported to be effective but associated with a risk of severe symptoms. Thus, an OIT method with decreased risk is required. Objectives: We aimed to evaluate the efficacy and safety of low- and high-dose OIT regimens in children with severe milk allergy. Methods: Overall, 33 participants (median age, 9 years; median final dose of the milk oral food challenge [OFC], 2 mL) were included. The participants were randomly assigned to groups that received either a low (20 mL; n = 19) or high (100 mL; n = 14) maintenance target dose of OIT. The dose was gradually increased to the target dose in the rush escalation phase and was then maintained daily at home. The primary endpoint was the final OFC dose at 6 months of OIT. Adverse events during OIT were evaluated. Results: The final OFC dose after OIT was significantly higher than that before OIT in both groups (low-dose, p = 0.000; high-dose, p = 0.006), but there was no significant difference in the final OFC dose between the 2 groups (p = 0.767). In the maintenance phase, the high-dose group had significantly more severe symptoms than did the low-dose group (0.5%, 11/2,355 total intake events vs. 0.1%, 4/3,230 total intake events; p = 0.018). Conclusions: An equally increased dose effect was observed for maintenance OIT doses of 20 and 100 mL in children with severe milk allergy. The risk of severe symptoms in the maintenance phase was lower in the low-dose group. A low-dose OIT regimen is recommended for severe milk allergy.
© 2020 S. Karger AG, Basel
Related Articles:
References
-
Flom JD, Sicherer SH. Epidemiology of cow’s milk allergy.
Nutrients . 2019 May;11(5):1051. -
Urisu A, Ebisawa M, Ito K, Aihara Y, Ito S, Mayumi M, et al. Japanese Guideline for Food Allergy 2014.
Allergol Int . 2014 Sep;63(3):399–419.External Resources -
Nurmatov U, Dhami S, Arasi S, Pajno GB, Fernandez-Rivas M, Muraro A, et al. Allergen immunotherapy for IgE-mediated food allergy: a systematic review and meta-analysis.
Allergy . 2017 Aug;72(8):1133–47.External Resources -
Staden U, Blumchen K, Blankenstein N, Dannenberg N, Ulbricht H, Dobberstein K, et al. Rush oral immunotherapy in children with persistent cow's milk allergy.
J Allergy Clin Immunol . 2008 Aug;122(2):418–9.External Resources -
Yanagida N, Sato S, Asaumi T, Okada Y, Ogura K, Ebisawa M. A single-center, case-control study of low-dose-induction oral immunotherapy with cow’s milk.
Int Arch Allergy Immunol . 2015;168(2):131–7.External Resources -
Yanagida N, Shukuya A, Sato S, Nagakura K, Emura S, Asaumi T, et al. Evaluation of a portable manual for parents of children with food allergies that assesses the severity of allergic symptoms.
Nihon Shoni Arerugi Gakkaishi The Japanese Journal of Pediatric Allergy and Clinical Immunology . 2014 Jan;28(2):201–10.External Resources -
Takahashi M, Taniuchi S, Soejima K, Hatano Y, Yamanouchi S, Kaneko K. Erratum to: Two-weeks-sustained unresponsiveness by oral immunotherapy using microwave heated cow's milk for children with cow's milk allergy.
Allergy Asthma Clin Immunol . 2016 Aug;12(1):57.External Resources -
Kulis M, Yue X, Guo R, Zhang H, Orgel K, Ye P, et al. High- and low-dose oral immunotherapy similarly suppress pro-allergic cytokines and basophil activation in young children.
Clin Exp Allergy . 2019 Feb;49(2):180–9.External Resources -
Maeta A, Matsushima M, Katahira R, Sakamoto N, Takahashi K. Diets supplemented with 1% egg white induce oral desensitization and immune tolerance in an egg white-specific allergic mouse model.
Int Arch Allergy Immunol . 2018;176(3–4):205–14.
Article / Publication Details
Received: February 21, 2020
Accepted: May 13, 2020
Published online: June 22, 2020
Issue release date: September 2020
Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 2
ISSN: 1018-2438 (Print)
eISSN: 1423-0097 (Online)
For additional information: https://www.karger.com/IAA
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
