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奥马珠单抗用于患有多种食物过敏的儿科患者的真实生活研究。

Real life study of the use of omalizumab for pediatric patients with multiple food allergies.

作者信息

Crespo Judit Barrena, Domingo Marta Viñas, Arauzo Nora Hernández, Castillo M José, Delavalle M Belén, Foix M Pilar Saura, Sánchez Davinia Vázquez, Izquierdo-Domínguez Adriana

机构信息

Department of Pediatric, Consorci Sanitari de Terrassa, Barcelona, Spain.

Department of Allergology, Consorci Sanitari de Terrassa, Barcelona, Spain.

出版信息

Allergol Immunopathol (Madr). 2021 Mar 1;49(2):15-22. doi: 10.15586/aei.v49i2.36. eCollection 2021.

Abstract

BACKGROUND

Multiple food allergies (MFAs) affect 30% of the child population with food allergy. The current treatment is the exclusion diet, which frequently affects the quality of life for these patients. The objective of the study was to describe the effect of omalizumab treatment in children diagnosed with MFAs who experienced frequent anaphylactic reactions and the impact on their quality of life.

MATERIAL AND METHODS

A descriptive observational study. Patients with severe food restrictions and high-risk due to multiple episodes of anaphylaxis were included. The allergy was confirmed by compatible clinical, skin tests, positive specific IgE and oral food challenges (OFCs). Omalizumab treatment was initiated and the impact on the life quality of patients and their families was assessed using the validated Food Allergy Quality of Life Questionnaire-Parent Form.

RESULTS

Five patients with an average age at diagnosis of 3.58 years (range between 1.5-7.9 years), were diagnosed with MFAs. All patients presented with anaphylaxis. All patients were treated with omalizumab between 2013 and 2019. Omalizumab treatment was initiated at a mean age of 6.05 years (range between 4.5-8.25 years). All patients have undergone OFC to reintroduce food successfully. 2 patients had their dose of omalizumab reduced by half, and 1 patient has had the time interval extended between administrations due to the maintenance of food tolerance. No immediate local or systemic adverse reactions were documented. Two patients have commenced omalizumab administration at home without incident.

CONCLUSIONS

Children with MFAs who are treated with omalizumab do not show reactions in response to most of the foods to which they previously had anaphylaxis. Consequently, these patients were able to significantly expand the variety of their diet, improving the life quality and avoid anaphylaxis following the inadvertent intake of these foods.

摘要

背景

多种食物过敏(MFA)影响30%的食物过敏儿童群体。目前的治疗方法是排除饮食法,这经常影响这些患者的生活质量。本研究的目的是描述奥马珠单抗治疗对诊断为MFA且频繁发生过敏反应的儿童的影响及其对生活质量的影响。

材料与方法

一项描述性观察研究。纳入因多次过敏反应而有严格食物限制和高风险的患者。通过相符的临床症状、皮肤试验、特异性IgE阳性和口服食物激发试验(OFC)确诊过敏。开始使用奥马珠单抗治疗,并使用经过验证的《食物过敏生活质量问卷-家长版》评估对患者及其家庭生活质量的影响。

结果

5例患者诊断时平均年龄为3.58岁(范围在1.5 - 7.9岁之间),被诊断为MFA。所有患者均出现过敏反应。所有患者在2013年至2019年期间接受了奥马珠单抗治疗。奥马珠单抗治疗开始时的平均年龄为6.05岁(范围在4.5 - 8.25岁之间)。所有患者均成功进行了OFC以重新引入食物。2例患者的奥马珠单抗剂量减半,1例患者由于维持了食物耐受性,给药时间间隔延长。未记录到即刻的局部或全身不良反应。2例患者已在家中开始使用奥马珠单抗给药,无不良事件发生。

结论

接受奥马珠单抗治疗的MFA儿童对大多数他们之前曾发生过敏反应的食物没有出现反应。因此,这些患者能够显著增加饮食种类,改善生活质量,并避免在无意中摄入这些食物后发生过敏反应。

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