Egg OIT in clinical practice (SEICAP II): Maintenance patterns and desensitization state after normalizing the diet.

Autor: Martín-Muñoz MF; Allergy Department, Pediatric Hospital La Paz (idiPaz), Madrid, Spain., Alonso Lebrero E; Allergy Department, Pediatric Hospital Gregorio Marañón, Madrid, Spain., Zapatero L; Allergy Department, Pediatric Hospital Gregorio Marañón, Madrid, Spain., Fuentes Aparicio V; Allergy Department, Pediatric Hospital Gregorio Marañón, Madrid, Spain., Piquer Gibert M; Allergy Section, Pediatric Hospital San Joan de Deu, Barcelona, Spain., Plaza Martín AM; Allergy Section, Pediatric Hospital San Joan de Deu, Barcelona, Spain., Muñoz C; Pediatric Allergy Section, Hospital Carlos Haya, Malaga, Spain., Belver MT; Allergy Department, Pediatric Hospital La Paz (idiPaz), Madrid, Spain., Martorell-Calatayud C; Allergy Department, General Hospital of Valencia, Valencia, Spain., Martorell-Aragonés A; Allergy Department, General Hospital of Valencia, Valencia, Spain., Blasco C; Allergy Department, Pediatric Hospital Vall d'Hebron, Barcelona, Spain., Vilá B; Allergy Department, Pediatric Hospital Vall d'Hebron, Barcelona, Spain., Gómez C; Allergy Department, Pediatric Hospital San Joan de Deu, Althaia, Manrresa, Spain., Nevot S; Allergy Department, Pediatric Hospital San Joan de Deu, Althaia, Manrresa, Spain., García Martín JM; Pediatric Allergy, Cruces Hospital, Bilbao, Spain., Madero R; Statistical Department, La Paz Hospital (idiPaz), Madrid, Spain., Echeverría L; Pediatric Allergy Section, Severo Ochoa Hospital, Madrid, Spain.
Jazyk: angličtina
Zdroj: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology [Pediatr Allergy Immunol] 2019 Mar; Vol. 30 (2), pp. 214-224. Date of Electronic Publication: 2018 Dec 18.
DOI: 10.1111/pai.13002
Abstrakt: Background: It is unknown which are the most suitable maintenance pattern and egg consumption to maintain the desensitization state after ending the oral immunotherapy (OIT). This multicenter, randomized, controlled trial compared two OIT maintenance patterns with pasteurized egg white (PEW), evaluating the egg consumption effect on the desensitization state after ending the OIT.
Methods: One hundred and one children with confirmed egg allergy were randomized: 25 to an egg-free diet (CG) and 76 to an OIT year with PEW and two maintenance patterns, 38 patients to daily 3.3 g proteins (AG) and 38 to every two days (BG). PEW challenge (DBPCFC), adverse reactions, and immune markers were assessed at baseline, at the end of the OIT, and at 6 and 12 months later on ad libitum egg consumption (T0, T12, T18, and T24). A questionnaire evaluated the egg consumption at T18.
Results: At T12, 64 of 76 (84.21%) OIT patients had reached total desensitization (32 AG and 32 BG) vs 4 of 25 (16.00%) CG who passed the PEW DBPCFC. Thirty (93.75%) AG vs 25 (78.12%) BG patients completed an OIT year. At T18, 27 of 29 (93.1%) AG vs 20 of 24 (83.3%) BG passed the PEW DBPCFC, 96% consuming at least two egg servings/week. At T24, 97.43% OIT patients passed the challenge. Most patients had adverse reactions, more frequent in the BG patients; frequency and severity of reactions decreased through the study. PEW skin prick test wheal and sIgE antibody serum levels similarly decreased in AG or BG, but AG patients had greater increase in PEW sIgG4 (P < 0.05).
Conclusions: Daily OIT maintenance achieves better adherence, effectiveness, and safety. Two egg servings/week ensure maintained desensitization after the end of an OIT year.
(© 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)
Databáze: MEDLINE
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