Efficacy and safety of oral immunotherapy for peanut, cow's milk, and hen's egg allergy: A systematic review of randomized controlled trials

被引：19
作者：
Lodge, Caroline J. [1 ,2 ]
Waidyatillake, Nilakshi [1 ]
Peters, Rachel L. [2 ,3 ]
Netting, Merryn [2 ,4 ,5 ]
Dai, Xin [1 ]
Burgess, John [1 ,2 ]
Hornung, Catherine J. [2 ]
Perrett, Kirsten P. [2 ,3 ,6 ]
Tang, Mimi L. K. [2 ,3 ,6 ,7 ]
Koplin, Jennifer J. [2 ,8 ]
Dharmage, Shyamali C. [1 ,2 ]
机构：
[1] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Allergy & Lung Hlth Unit, Carlton, Vic 3053, Australia
[2] Murdoch Childrens Res Inst, Ctr Food & Allergy Res, Parkville, Vic, Australia
[3] Univ Melbourne, Dept Pediat, Parkville, Vic, Australia
[4] South Australian Hlth & Med Res Inst SAHMRI, Women & Kids Theme, Adelaide, SA, Australia
[5] Univ Adelaide, Discipline Paediat, Adelaide, SA, Australia
[6] Royal Childrens Hosp, Dept Allergy & Immunol, Melbourne, Vic, Australia
[7] Murdoch Childrens Res Inst, Allergy Immunol, Parkville, Vic, Australia
[8] Univ Queensland, Child Res Ctr, South Brisbane, Qld, Australia
来源：
CLINICAL AND TRANSLATIONAL ALLERGY | 2023年 / 13卷 / 07期
关键词：
desensitization; food allergy; oral immunotherapy; randomized controlled trials; sustained unresponsiveness; MEDIATED FOOD ALLERGY; DOUBLE-BLIND; CHILDREN; PREVALENCE; AR101; RISK;
D O I：
10.1002/clt2.12268
中图分类号：
R392 [医学免疫学];
学科分类号：
100102 ;
摘要：
BackgroundOral immunotherapy (OIT) is a promising treatment for food allergies; however, safety is a concern. We synthesized evidence from the best randomized controlled trials (RCTs) on efficacy/safety of OIT for desensitization (DS) and remission (sustained unresponsiveness (SU)) in IgE mediated allergy to peanut, hen's eggs, and cow's milk. BodyWe searched Pubmed, EMBASE, and Cochrane databases (Until Oct 22) identifying 16 eligible RCTs published in English measuring food allergy by food challenge at the beginning and at the end of the study. The Cochrane Risk of Bias tool was used to assess study quality. We found 18 eligible studies. There was evidence of efficacy for DS for all allergens: peanut (RR 11.32; 95% CI 5.93, 21.60, I-2 49%, 8 studies); hen's egg (RR 4.67; 2.66, 8.21, I-2 0%, 5 studies); cow's milk (RR 13.98; 3.51, 55.65, I-2 0%, 4 studies) and evidence for SU for peanut (RR 7.74; 2.90, 20.69, I-2 0%, 3 studies) and hen's egg (RR 6.91; 1.67, 28.57, I-2 0%, 2 studies). Allergic events were increased with intervention, and risk of adrenaline use increased for peanut RR 2.96; 1.63, 5.35, I-2 0%, 8 studies; egg RR 1.71; 0.42, 6.92, I-2 0%, 6 studies; and milk RR 8.45; 2.02, 35.27, I-2 0%, 4 studies. ConclusionWe found strong evidence that peanut, hen's egg, and cow's milk OIT can induce DS and some evidence for remission. There was a high risk of allergic reactions. Generalizability to the entire food allergic population is not known.
引用
收藏
页数：26
相关论文
共 50 条
[21]   The safety and efficacy of sublingual and oral immunotherapy for milk allergy [J].
Keet, Corinne A. ;
Frischmeyer-Guerrerio, Pamela A. ;
Thyagarajan, Ananth ;
Schroeder, John T. ;
Hamilton, Robert G. ;
Boden, Stephen ;
Steele, Pamela ;
Driggers, Sarah ;
Burks, A. Wesley ;
Wood, Robert A. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2012, 129 (02) :448-U264
[22]   Randomized controlled trial of oral immunotherapy for egg allergy in Japanese patients [J].
Akashi, Masayuki ;
Yasudo, Hiroki ;
Narita, Masami ;
Nomura, Ichiro ;
Akasawa, Akira ;
Ebisawa, Motohiro ;
Takahashi, Takao ;
Ohya, Yukihiro .
PEDIATRICS INTERNATIONAL, 2017, 59 (05) :534-539
[23]   Oral immunotherapy for IgE-mediated cow's milk allergy: a systematic review and meta-analysis [J].
Brozek, J. L. ;
Terracciano, L. ;
Hsu, J. ;
Kreis, J. ;
Compalati, E. ;
Santesso, N. ;
Fiocchi, A. ;
Schuenemann, H. J. .
CLINICAL AND EXPERIMENTAL ALLERGY, 2012, 42 (03) :363-374
[24]   Early oral immunotherapy in infants with cow's milk protein allergy [J].
Berti, Irene ;
Badina, Laura ;
Cozzi, Giorgio ;
Giangreco, Manuela ;
Bibalo, Cristina ;
Ronfani, Luca ;
Barbi, Egidio ;
Ventura, Alessandro ;
Longo, Giorgio .
PEDIATRIC ALLERGY AND IMMUNOLOGY, 2019, 30 (05) :572-574
[25]   A Randomized, Open-Label Trial of Hen's Egg Oral Immunotherapy: Efficacy and Humoral Immune Responses in 50 Children [J].
Palosuo, Kati ;
Karisola, Piia ;
Savinko, Terhi ;
Fyhrquist, Nanna ;
Alenius, Harri ;
Makela, Mika J. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2021, 9 (05) :1892-+
[26]   Oral immunotherapy for peanut allergy (PACE): a systematic review and meta-analysis of efficacy and safety [J].
Chu, Derek K. ;
Wood, Robert A. ;
French, Shannon ;
Fiocchi, Alessandro ;
Jordana, Manel ;
Waserman, Susan ;
Brozek, Jan L. ;
Schuenemann, Holger J. .
LANCET, 2019, 393 (10187) :2222-2232
[27]   Two-weeks-sustained unresponsiveness by oral immunotherapy using microwave heated cow's milk for children with cow's milk allergy [J].
Takahashi, Masaya ;
Taniuchi, Shoichiro ;
Soejima, Kazuhiko ;
Hatano, Yasuko ;
Yamanouchi, Sohsaku ;
Kaneko, Kazuanri .
ALLERGY ASTHMA AND CLINICAL IMMUNOLOGY, 2016, 12
[28]   Evaluation of baked egg oral immunotherapy in French children with hen's egg allergy [J].
Gruzelle, Vianney ;
Juchet, Agnes ;
Martin-Blondel, Audrey ;
Michelet, Marine ;
Chabbert-Broue, Anne ;
Didier, Alain .
PEDIATRIC ALLERGY AND IMMUNOLOGY, 2021, 32 (05) :1022-1028
[29]   The effect of oral immunotherapy treatment in severe IgE mediated milk, peanut, and egg allergy in adults [J].
Mantyla, Jarkko ;
Thomander, Tuuli ;
Hakulinen, Auli ;
Kukkonen, Kaarina ;
Palosuo, Kati ;
Voutilainen, Helena ;
Pelkonen, Anna ;
Kauppi, Paula .
IMMUNITY INFLAMMATION AND DISEASE, 2018, 6 (02) :307-311
[30]   The efficacy of oral and subcutaneous antigen-specific immunotherapy in murine cow's milk- and peanut allergy models [J].
Vonk, Marlotte M. ;
Wagenaar, Laura ;
Pieters, Raymond H. H. ;
Knippels, Leon M. J. ;
Willemsen, Linette E. M. ;
Smit, Joost J. ;
van Esch, Betty C. A. M. ;
Garssen, Johan .
CLINICAL AND TRANSLATIONAL ALLERGY, 2017, 7
12345