Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel.
Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel.
J Allergy Clin Immunol Pract. 2019 Feb;7(2):429-436.e2. doi: 10.1016/j.jaip.2018.06.016. Epub 2018 Jul 7.
Oral immunotherapy (OIT) for food allergy is demanding but data on patients' quality of life (QOL) throughout the process are limited.
To characterize changes in QOL of food-allergic patients during and after OIT.
In a prospective cohort study, the Food Allergy Quality of Life Questionnaire-Parental Form (FAQLQ-PF) was administered to parents of 191 consecutive children aged 4 to 12 years undergoing OIT for food allergy. Questionnaires were administered at OIT initiation, mid up-dosing, upon reaching maintenance, and after 6 months of follow-up. Age- and sex-matched food-allergic children (n = 48) not undergoing OIT served as controls.
FAQLQ-PF scores had significantly improved (decreased) from OIT initiation to reaching full maintenance (emotional impact [EI], 3.66-3.32, P = .001; food anxiety [FA], 3.90-3.32, P < .001; social and dietary limitation [SDL], 3.50-2.94, P < .001; and total score, 3.69-3.19, P < .001) and partial maintenance, whereas no change was noted in control patients. Worse baseline QOL, single food allergy, and a younger age predicted greater QOL improvement. Of the 85 (88.5%) patients who completed the FAQLQ-PF at mid up-dosing and for whom QOL deteriorated, a significant improvement was noted upon reaching maintenance. Additional significant improvement in QOL was observed in the 95 (88.8%) patients who completed the FAQLQ-PF 6 months after reaching maintenance (EI, 3.414-2.993, P = 0.049; FA, 3.37-2.593, P = .001; SDL, 2.989-2.264, P = .001; and total score, 3.266-2.614, P = .001).
The QOL of food-allergic children improves significantly upon reaching OIT maintenance, with additional improvement 6 months later. The detrimental effect of OIT on some patients' QOL during up-dosing is reversed upon reaching maintenance.
口服免疫疗法（OIT）治疗食物过敏要求较高，但有关患者整个过程中生活质量（QOL）的数据有限。
描述 OIT 过程中及结束后食物过敏患者 QOL 的变化。
在一项前瞻性队列研究中，对 191 名 4 至 12 岁接受 OIT 治疗的食物过敏儿童的父母进行了食物过敏生活质量问卷-父母版（FAQLQ-PF）问卷调查。在 OIT 开始时、中剂量增加时、达到维持剂量时和 6 个月随访时进行问卷调查。48 名年龄和性别匹配的未接受 OIT 的食物过敏儿童作为对照组。
FAQLQ-PF 评分从 OIT 开始到达到完全维持（情感影响[EI]，3.66-3.32，P=.001；食物焦虑[FA]，3.90-3.32，P<.001；社会和饮食限制[SDL]，3.50-2.94，P<.001；总分，3.69-3.19，P<.001）和部分维持时显著改善，而对照组患者的评分没有变化。基线 QOL 较差、单一食物过敏和年龄较小预示着 QOL 改善更大。在 85 名（88.5%）在中剂量增加时完成 FAQLQ-PF 并出现 QOL 恶化的患者中，达到维持时，QOL 显著改善。在 95 名（88.8%）完成 FAQLQ-PF 并在达到维持后 6 个月的患者中，QOL 进一步显著改善（EI，3.414-2.993，P=0.049；FA，3.37-2.593，P=.001；SDL，2.989-2.264，P=.001；总分，3.266-2.614，P=.001）。
达到 OIT 维持剂量后，食物过敏儿童的 QOL 显著改善，6 个月后进一步改善。在达到维持剂量时，一些患者在剂量增加过程中 QOL 受到的不利影响得到逆转。
