Real-world safety and effectiveness analysis of low-dose preschool sesame oral immunotherapy.

Autor:	Chua GT; Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.; Allergy Centre, Union Hospital, Hong Kong, China.; Department of Paediatrics, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China., Soller L; Division of Allergy, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia., Kapur S; Division of Allergy, Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada.; Halifax Allergy and Asthma Associates, Halifax, Nova Scotia, Canada., McHenry M; Division of Allergy, Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada.; Halifax Allergy and Asthma Associates, Halifax, Nova Scotia, Canada., Rex GA; Division of Allergy, Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada.; Halifax Allergy and Asthma Associates, Halifax, Nova Scotia, Canada., Cook VE; Division of Allergy, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia.; Community Allergy Clinic, Victoria, British Columbia., Cameron SB; Division of Allergy, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia.; Community Allergy Clinic, Victoria, British Columbia., Chan ES; Division of Allergy, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia., Yeung J; Division of Allergy, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia., Erdle SC; Division of Allergy, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia.
Jazyk:	angličtina
Zdroj:	The journal of allergy and clinical immunology. Global [J Allergy Clin Immunol Glob] 2023 Sep 23; Vol. 3 (1), pp. 100171. Date of Electronic Publication: 2023 Sep 23 (Print Publication: 2024).
DOI:	10.1016/j.jacig.2023.100171
Abstrakt:	Background: Previous studies support the effectiveness of sesame oral immunotherapy (S-OIT) in patients >4 years old using maintenance doses of 1200 mg protein. However, tahini is often not palatable to children, and high-maintenance doses may not be possible for preschoolers. Objective: We studied the safety and effectiveness outcomes of preschoolers with sesame allergy who underwent low-dose S-OIT of 200 mg protein. Methods: Preschoolers with sesame allergy, with a history of objective reaction to sesame, and with either a positive skin prick test result (wheal diameter ≥3 mm) or sesame-specific IgE level ≥0.35 kU/L were included. Doses were escalated every 2 to 4 weeks until the maintenance dose of 200 mg of sesame protein was reached. The maintenance dose was continued daily for 1 year, followed by exit oral food challenge (OFC). Primary safety outcomes included allergic reactions grade 2 or higher and the need for epinephrine therapy during buildup. The primary effectiveness outcome was proportion of patients tolerating a minimum of 2000 mg sesame protein at exit OFC. Results: Twenty-eight preschoolers (median age, 33.5 months) were enrolled to receive S-OIT. During the buildup phase, 9 subjects (32.1%) had no reaction, and 8 (28.6%) and 11 (39.3%) had grade 1 and 2 reactions, respectively. One patient (3.57%) received epinephrine for a grade 2 reaction. Twenty-one (91.3%) of 23 eligible subjects underwent exit OFC; 18 (85.7%) of these 21 patients successfully completed exit OFC. One (4.8%) and 2 (9.5%) subjects had grade 1 and 2 reactions, respectively, during OFC. Conclusions: A lower and age-appropriate maintenance dose is safe and effective in desensitizing preschoolers with sesame allergy. (© 2023 The Author(s).)
Databáze:	MEDLINE
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