Paediatric Allergies, Immunology and Pneumology Unit, Paediatric Medicine Service, Parc Tauli Hospital Universitari. Institut d'Investigació i Innovació Parc Tauli (I3PT). Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain;
Paediatric Allergies, Immunology and Pneumology Unit, Paediatric Medicine Service, Parc Tauli Hospital Universitari. Institut d'Investigació i Innovació Parc Tauli (I3PT). Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
Allergol Immunopathol (Madr). 2022 May 1;50(3):1-7. doi: 10.15586/aei.v50i3.537. eCollection 2022.
Oral immunotherapy (OIT) is a promising approach to cow's milk and egg allergies, but reactions are frequent and some patients cannot be desensitized.
To evaluate long-term OIT outcomes with omalizumab (OMZ) in paediatric patients with severe egg and/or milk allergies.
This retrospective real-life study analysed findings in children with Immunoglobulin E-mediated allergy to cow's milk and/or hen eggs refractory to conventional OIT, who underwent OIT with OMZ in our department between 1 January 2010 and 31 December 2015.
In all, 41 patients were included (median age: 7 years; interquartile range [IQR]: 5.5-9.5); 26/41 (63.4%) underwent OIT for milk, 8/41 (19.5%) for egg and 7/41 (17.1%) for both. The median time between initiation of OMZ and OIT was 27 weeks (IQR: 22-33). Forty (97.56%) patients reached the maintenance phase (200 mL of cow's milk and 30 mL of raw egg or 1 cooked egg) in a median time of 27 weeks (IQR: 18-37). The median total time with OMZ was 117 weeks (IQR: 88-144). During the OMZ period, 2.44% (1/41) of patients presented anaphylaxis. After discontinuation of OMZ, 29.3% (12/41) presented anaphylaxis, 50% of them had a poor adherence to daily ingestion. One patient (2.44%) was diagnosed with eosinophilic esophagitis after 2 years of discontinuation of OMZ. Currently, after a median time of 9 years (IQR: 7-10) since the initiation of OMZ, 75.6% (31/41) are desensitized (27/31 without OMZ).
Omalizumab allows desensitisation of children with severe allergies to cow's milk and/or egg without developing severe reactions while receiving this treatment. However, discontinuation of OMZ leads to severe allergic reactions, and hence must be monitored carefully.
口服免疫疗法（OIT）是治疗牛奶和鸡蛋过敏的一种很有前途的方法，但会经常出现反应，而且有些患者无法脱敏。
评估奥马珠单抗（OMZ）在儿科重度鸡蛋和/或牛奶过敏患者中的长期 OIT 结果。
这项回顾性真实世界研究分析了 2010 年 1 月 1 日至 2015 年 12 月 31 日期间在我科接受 OMZ 治疗的对牛奶和/或鸡蛋不耐受的 IgE 介导过敏的儿童的 OIT 结果。
共纳入 41 例患者（中位年龄：7 岁；四分位距 [IQR]：5.5-9.5）；26/41（63.4%）患者接受 OIT 治疗牛奶过敏，8/41（19.5%）患者接受 OIT 治疗鸡蛋过敏，7/41（17.1%）患者接受 OIT 治疗牛奶和鸡蛋过敏。从开始使用 OMZ 到开始 OIT 的中位时间为 27 周（IQR：22-33）。40 例（97.56%）患者在中位时间 27 周（IQR：18-37）内达到维持阶段（200 毫升牛奶和 30 毫升生鸡蛋或 1 个熟鸡蛋）。使用 OMZ 的中位总时间为 117 周（IQR：88-144）。在 OMZ 期间，2.44%（1/41）的患者出现过敏反应。停用 OMZ 后，12/41（29.3%）的患者出现过敏反应，其中 50%的患者对每日摄入的药物依从性差。停用 OMZ 2 年后，1 例（2.44%）患者被诊断为嗜酸性食管炎。目前，在开始使用 OMZ 后中位时间 9 年（IQR：7-10）后，75.6%（31/41）的患者脱敏（31 例无 OMZ）。
奥马珠单抗可使儿童对牛奶和/或鸡蛋的严重过敏脱敏，同时在接受治疗时不会出现严重反应。然而，停用 OMZ 会导致严重的过敏反应，因此必须密切监测。
