Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Italy.
Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Italy.
J Allergy Clin Immunol Pract. 2019 Jul-Aug;7(6):1901-1909.e5. doi: 10.1016/j.jaip.2019.01.023. Epub 2019 Feb 20.
The effects of omalizumab on food allergy thresholds have been little studied.
To assess the real-life effects of omalizumab on food threshold tolerability in children treated for severe asthma.
In this observational, real-life, efficacy study, we reviewed the food allergen thresholds of patients with severe asthma, as well as their immediate reactions to 2+ foods before and after a 4-month treatment with omalizumab. We also evaluated their control of asthma and their quality of life, as measured by Pediatric Quality of Life Inventory (PedsQL).
Fifteen children, allergic to 37 foods, were evaluated. Omalizumab induced an increase in the allergen threshold for milk, egg, wheat, and hazelnut from a mean 1012.6 ± 1464.5 mg protein to 8727 ± 6463.3 eliciting dose (P < .001). A total of 70.4% of subjects tolerated the complete challenge dose after 4 months of treatment with omalizumab. These foods were reintroduced in the patients' diet without the need for any oral immunotherapy procedures. The remaining foods were partially tolerated. The number of reactions to the unintended ingestion of allergenic foods over 4 months dropped from 47 to 2. The PedsQL increased from 61 ± 5.32 to 87 ± 7.33 (parental judgment; P < .001) and from 65 ± 7.39 to 90 ± 4.54 (patients' judgment; P < .001). The mean cost of omalizumab was €1311.63 per month.
During treatment with omalizumab for severe uncontrolled asthma, the food allergen threshold increases to 8.6 times its original value. The quality of life of patients also increased, due to a better asthma control and a reduction in dietary restrictions. The cost/benefit ratio of such treatment for selected cases of food allergy remains to be evaluated.
奥马珠单抗对食物过敏阈值的影响尚未得到充分研究。
评估奥马珠单抗在治疗严重哮喘儿童中对食物阈值耐受性的实际影响。
在这项观察性、真实生活、疗效研究中，我们回顾了严重哮喘患者的食物过敏原阈值，以及他们在接受奥马珠单抗治疗 4 个月前后对 2+食物的即刻反应。我们还评估了他们的哮喘控制情况和生活质量，使用儿童生活质量量表（PedsQL）进行评估。
共评估了 15 名对 37 种食物过敏的儿童。奥马珠单抗诱导牛奶、鸡蛋、小麦和榛子的过敏原阈值从平均 1012.6±1464.5mg 蛋白增加到 8727±6463.3 激发剂量（P<0.001）。4 个月奥马珠单抗治疗后，70.4%的患者能够耐受完整的挑战剂量。这些食物被重新引入患者的饮食中，无需进行任何口服免疫治疗程序。其余食物部分耐受。4 个月内无意中摄入过敏原食物的反应次数从 47 次减少到 2 次。PedsQL 从 61±5.32 增加到 87±7.33（家长判断；P<0.001）和从 65±7.39 增加到 90±4.54（患者判断；P<0.001）。奥马珠单抗的平均月费用为 1311.63 欧元。
在严重未控制哮喘的奥马珠单抗治疗期间，食物过敏原阈值增加到原始值的 8.6 倍。由于哮喘控制更好和饮食限制减少，患者的生活质量也提高了。对于某些食物过敏病例，这种治疗的成本效益比仍有待评估。
