Risk factors associated with safety of preschool peanut oral immunotherapy.

Autor:	Karunakaran D; British Columbia Children's Hospital, Vancouver, British Columbia.; Department of Medicine, Queen's University, Kingston, Ontario., Chan ES; British Columbia Children's Hospital, Vancouver, British Columbia.; Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, British Columbia., Zhang Q; British Columbia Children's Hospital, Vancouver, British Columbia., Bone JN; British Columbia Children's Hospital, Vancouver, British Columbia., Carr S; Snö Asthma & Allergy Clinic, Abu Dhabi, United Arab Emirates., Kapur S; Department of Pediatrics, Division of Allergy, Dalhousie University/IWK Health Centre, Halifax.; Halifax Allergy & Asthma Associates, Halifax, Nova Scotia., Rex GA; Department of Pediatrics, Division of Allergy, Dalhousie University/IWK Health Centre, Halifax.; Halifax Allergy & Asthma Associates, Halifax, Nova Scotia., McHenry M; Department of Pediatrics, Division of Allergy, Dalhousie University/IWK Health Centre, Halifax.; Halifax Allergy & Asthma Associates, Halifax, Nova Scotia., Cameron SB; Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, British Columbia.; Community Allergy Clinic, Victoria, British Columbia., Cook VE; Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, British Columbia.; Community Allergy Clinic, Victoria, British Columbia., Leo S; Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, British Columbia.; West Coast Allergy and Immunology Clinic, Vancouver, British Columbia., Wong T; British Columbia Children's Hospital, Vancouver, British Columbia.; Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, British Columbia., Gerstner TV; Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Manitoba.; Meadowood Medical Center, Winnipeg, Manitoba., Yeung J; Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, British Columbia.; Meadowood Medical Center, Winnipeg, Manitoba.; Vancouver Kids Allergy, Vancouver, British Columbia., Abrams EM; Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, British Columbia.; Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Manitoba.; Meadowood Medical Center, Winnipeg, Manitoba., Mak R; British Columbia Children's Hospital, Vancouver, British Columbia.; Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, British Columbia., Erdle SC; British Columbia Children's Hospital, Vancouver, British Columbia.; Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, British Columbia., Soller L; British Columbia Children's Hospital, Vancouver, British Columbia.; Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, British Columbia.
Jazyk:	angličtina
Zdroj:	The journal of allergy and clinical immunology. Global [J Allergy Clin Immunol Glob] 2023 Mar 21; Vol. 2 (2), pp. 100094. Date of Electronic Publication: 2023 Mar 21 (Print Publication: 2023).
DOI:	10.1016/j.jacig.2023.100094
Abstrakt:	Background: An understanding of how patient characteristics such as age, baseline peanut-specific IgE, and atopic comorbidities may influence potential safety outcomes during peanut oral immunotherapy (P-OIT) could aid in shared decision making between clinicians and patient families. Objective: This study explored the relationship between baseline patient characteristics and reactions during P-OIT using a large sample size to better understand potential risk factors influencing P-OIT safety. Methods: Data were obtained from the Food Allergy Immunotherapy (FAIT) registry, which collects real-world OIT data from community and academic allergy clinics across Canada. Multivariable logistic regression modeling was performed to examine the relationship between baseline patient characteristics and reactions during P-OIT. Multiple imputation was applied to reduce potential bias caused by missingness and to maximize the use of available information to preserve statistical power. Results: Between April 2017 and June 2021, a total of 653 eligible patients initiated P-OIT. Multivariable regression analysis showed pre-OIT grade 2+ initial reaction (odds ratio [OR] = 1.33, 95% confidence interval [CI] 1.10, 1.61), allergic rhinitis (OR = 1.60, 95% CI 1.08, 2.38), older age (OR = 1.01, 95% CI 1.00, 1.02), and higher baseline peanut-specific IgE (OR = 1.02, 95% CI 1.02, 1.03) were associated with grade 2+ reaction during P-OIT after adjusting for potential risk factors. Conclusion: Our study identified several clinically important risk factors for grade 2+ reactions during P-OIT: pre-OIT grade 2+ initial reaction, allergic rhinitis, older age, and higher baseline peanut-specific IgE. These results highlight the need for individualized risk stratification for OIT. (© 2023 The Authors.)
Databáze:	MEDLINE
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