Oral Immunotherapy for Peanut Allergy: Multipractice Experience With Epinephrine-treated Reactions

被引：92

作者：

Wasserman, Richard L. ^{[1
]}

Factor, Jeffrey M. ^{[2
]}

Baker, James W. ^{[3
]}

Mansfield, Lyndon E. ^{[4
]}

Katz, Yitzhak ^{[5
]}

Hague, Angela R. ^{[6
]}

Paul, Marianne M. ^{[3
]}

Sugerman, Robert W. ^{[1
]}

Lee, Jason O. ^{[2
]}

Lester, Mitchell R. ^{[2
]}

Mendelson, Louis M. ^{[2
]}

Nacshon, Liat ^{[7
]}

Levy, Michael B. ^{[7
]}

Goldberg, Michael R. ^{[7
]}

Elizur, Arnon ^{[5
]}

机构：

[1] Med City Childrens Hosp, Dept Pediat, Dallas, TX 75230 USA

[2] Connecticut Childrens Med Ctr, New England Food Allergy Treatment Ctr, Hartford, CT USA

[3] Emanuel Hosp & Hlth Ctr, Dept Allergy & Immunol, Portland, OR USA

[4] Paul Foster Sch Med, El Paso, TX USA

[5] Tel Aviv Univ, Sackler Sch Med, Zerifin Israel & Dept Pediat, IL-69978 Tel Aviv, Israel

[6] DallasAllergyImmunol, Dallas, TX USA

[7] Asaf Harofe Med Ctr, Allergy & Immunol Inst, Zerifin, Israel

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE | 2014年 / 2卷 / 01期

关键词：

Peanut; Oral immunotherapy; Food allergy; Food allergy treatment; QUALITY-OF-LIFE; FATAL ANAPHYLACTIC REACTIONS; HEALTH-RELATED QUALITY; FOOD ALLERGY; PSYCHOSOCIAL IMPACT; SYSTEMIC REACTIONS; NATURAL-HISTORY; CHILDREN; DESENSITIZATION; SAFETY;

D O I：

10.1016/j.jaip.2013.10.001

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

BACKGROUND: Peanut allergy creates the risk of life-threatening anaphylaxis that can disrupt psychosocial development and family life. The avoidance management strategy often fails to prevent anaphylaxis and may contribute to social dysfunction. Peanut oral immunotherapy may address these problems, but there are safety concerns regarding implementation in clinical practice. OBJECTIVE: The purpose of this report is to communicate observations about the frequency of epinephrine-treated reactions during peanut oral immunotherapy in 5 different allergy/immunology practices. METHODS: Retrospective chart review of peanut oral immunotherapy performed in 5 clinical allergy practices. RESULTS: A total of 352 treated patients received 240,351 doses of peanut, peanut butter, or peanut flour, and experienced 95 reactions that were treated with epinephrine. Only 3 patients received 2 doses of epinephrine, and no patient required more intensive treatment. A total of 298 patients achieved the target maintenance dose for a success rate of 85%. CONCLUSION: Peanut oral immunotherapy carries a risk of systemic reactions. In the context of oral immunotherapy, those reactions were recognized and treated promptly. Peanut oral immunotherapy may be a suitable therapy for patients managed by qualified allergists/immunologists. (C) 2014 American Academy of Allergy, Asthma & Immunology

引用

页码：91 / +

页数：8

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