Oral immunotherapy in severe cow's milk allergic patients treated with omalizumab: Real life survey from a Spanish registry
| Autor: | Joan Bartra, Paloma Poza Guedes, María Dolores Ibáñez-Sandín, Ana M Montoro de Francisco, Catalina Gómez Galán, María Flora Martín-Muñoz, Pablo Rodríguez del Río, Rosa García Rodríguez, C. Escudero, Antonio Ramírez Jiménez, Juan C Miralles, Vanessa Gázquez García, María D Martos Calahorro, Eva Marchán-Martín, Ángel Abellán, José Meseguer Arce, Soledad Terrados, E. M. Lasa, Rocío Candón Morillo, Ana I. Tabar, Carlos González Díaz, A Martorell, Sonsoles Juste, S. Sanchez-Garcia |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Allergy Immunology Milk allergy Omalizumab Immunoglobulin E 03 medical and health sciences 0302 clinical medicine Food allergy Internal medicine medicine anaphylaxis Immunology and Allergy Animals Humans 030212 general & internal medicine Registries OmaBASE biology business.industry Oral food challenge real‐ anti‐ food and beverages oral immunotherapy medicine.disease Milk Proteins Discontinuation Milk 030228 respiratory system life studies Desensitization Immunologic Pediatrics Perinatology and Child Health food desensitization biology.protein off‐ omalizumab Cattle Female IgE label therapy severe food allergy Milk Hypersensitivity business cow`s milk allergy Anaphylaxis medicine.drug |
| Zdroj: | PEDIATRIC ALLERGY AND IMMUNOLOGY r-FISABIO. Repositorio Institucional de Producción Científica instname |
| ISSN: | 1399-3038 0905-6157 |
| Popis: | Background Oral immunotherapy is a frequent treatment for the management of food allergies, but adverse events (AE) are common. This study assessed the outcome of cow's milk oral immunotherapy (MOIT) in severe cow`s milk-allergic patients treated with omalizumab in a real-life setting. Methods OmaBASE was a national, multicenter, open, and observational registry that collected clinical, immunologic, and treatment from patients with food allergy receiving omalizumab. Results Data derived from 58 patients aged 10.3 years (IQR 6.3-13.2) and median milk-specific IgE 100 kU(A)/L at the start of omalizumab treatment. Most had experienced anaphylaxis by accidental exposures (70.7%) and had asthma (81.0%). Omalizumab in monotherapy induced tolerance to >= 6000 mg of cow's milk protein (CMP) to 34.8% of patients tested by oral food challenge. Omalizumab combined with MOIT conferred desensitization to >= 6000 mg of CMP to 83.0% of patients. Omalizumab withdrawal triggered more AE (P = .013) and anaphylaxis (P = .001) than no discontinuation. Anaphylaxis was observed in 36.4% of patients who discontinued omalizumab, and more in those with sudden (50.0%) rather than progressive (12.5%) discontinuation. At database closure, 40.5% of patients who had completed follow-up tolerated CMP without omalizumab (7.2% 1500-4500 mg; 33.3% >= 6000 mg). Conclusion Milk oral immunotherapy initiated under omalizumab allows the desensitization of subjects with severe cow's milk allergy even after omalizumab discontinuation. However, discontinuation of omalizumab can lead to severe AE and should be carefully monitored. |
| Databáze: | OpenAIRE |
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