Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, Calif.
Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, Calif; Clinical Immunology Unit, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy; Department of Internal Medicine, San Paolo Hospital, Savona, Italy.
J Allergy Clin Immunol Pract. 2021 Oct;9(10):3705-3714. doi: 10.1016/j.jaip.2021.05.020. Epub 2021 Jun 2.
Food allergy (FA) is a growing global problem that can affect patients' health-related quality of life (HRQoL) owing to increased anxiety as well as social and economic restrictions. Interventions such as oral food challenges (OFCs) and oral immunotherapy (OIT) have been shown to improve HRQoL. However, meta-analyses and systematic synthesis of these data are lacking.
To review and quantitatively synthesize potential benefits of interventions (OIT and OFC) systematically to address FA to a variety of foods.
We conducted a systematic search through PubMed and Cochrane Medical Library databases and performed a meta-analysis focusing on studies assessing changes in HRQoL after OIT and/or OFCs in FA participants and caregivers from 2010 to July 2020. Random effects model and I statistics were used to assess overall intervention effects and heterogeneity across studies.
We included 13 publications in this meta-analysis (OIT = 7; OFCs = 6). Mean change in HRQoL scores after OIT and OFCs was -1.25 (P < .001) and -0.78 (P = .052), with a significant I of 87% (P < .001) and 90% (P < .001), respectively. Five OIT studies found significant improvements in HRQoL in the OIT group compared with the placebo group, with an overall standardized mean difference of -0.56 (P = .007; I = 42%, P = .099).
This meta-analysis showed that in FA patients, both OIT and OFCs are associated with an improvement in HRQoL. Well-designed and long-term HRQoL studies are necessary to ascertain sustained benefits of OIT and OFCs.
食物过敏（FA）是一个日益严重的全球性问题，由于焦虑增加以及社会和经济限制，会影响患者的健康相关生活质量（HRQoL）。口服食物挑战（OFC）和口服免疫疗法（OIT）等干预措施已被证明可以改善 HRQoL。然而，缺乏对这些数据的荟萃分析和系统综合。
综述和定量综合各种食物 FA 的干预措施（OIT 和 OFC）的潜在益处。
我们通过 PubMed 和 Cochrane 医学图书馆数据库进行了系统搜索，并进行了一项荟萃分析，重点关注 2010 年至 2020 年 7 月期间接受 OIT 和/或 OFC 后 FA 参与者和照顾者的 HRQoL 变化的研究。使用随机效应模型和 I 统计量评估整体干预效果和研究之间的异质性。
我们将 13 篇文献纳入本荟萃分析（OIT=7；OFC=6）。OIT 和 OFC 后 HRQoL 评分的平均变化分别为-1.25（P<.001）和-0.78（P=.052），I 分别为 87%（P<.001）和 90%（P<.001）。五项 OIT 研究发现 OIT 组与安慰剂组相比 HRQoL 显著改善，总体标准化均数差为-0.56（P=.007；I=42%，P=.099）。
本荟萃分析表明，在 FA 患者中，OIT 和 OFC 均与 HRQoL 改善相关。需要进行精心设计和长期的 HRQoL 研究，以确定 OIT 和 OFC 的持续获益。
