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达到牛奶口服免疫治疗维持的患者的长期依从性和过敏反应风险。

Long-Term Adherence and Risk of Allergic Reactions in Patients Who Attained Milk Oral Immunotherapy Maintenance.

机构信息

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.

Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.

出版信息

J Allergy Clin Immunol Pract. 2024 Oct;12(10):2811-2816.e2. doi: 10.1016/j.jaip.2024.06.031. Epub 2024 Jun 27.

Abstract

BACKGROUND

Oral immunotherapy (OIT) has emerged as the most popular therapy for food allergy. However, data on the long-term adherence and efficacy of this approach are sparse.

OBJECTIVE

We aimed to assess the long-term adherence rates to OIT protocol and the associated risk of allergic reactions.

METHODS

Patients who completed milk OIT and reached a maintenance dose of 200 mL of milk were surveyed biannually on their dairy consumption and occurrence of allergic reactions. A survival analysis was performed to evaluate the association between the risk of reaction and the adherence to OIT maintenance protocol.

RESULTS

The cohort consisted of 50 patients. Only 56% of the cohort adhered to the protocol, which consisted of ingesting a minimum of 200 mL of milk at least 3 times per week. Adherent patients had a significantly reduced risk of allergic reactions as well as a reduced incidence of anaphylaxis, health care/emergency room visits, and epinephrine/antihistamine administration.

CONCLUSIONS

The findings demonstrate the importance of consistent maintenance dose consumption in the management of food allergies, with regular milk consumption contributing to the maintenance of unresponsiveness and decreased risk of allergic symptoms.

摘要

背景

口服免疫疗法(OIT)已成为治疗食物过敏最受欢迎的疗法。然而,关于这种方法的长期依从性和疗效的数据很少。

目的

我们旨在评估 OIT 方案的长期依从率以及与过敏反应相关的风险。

方法

对完成牛奶 OIT 并达到 200 毫升牛奶维持剂量的患者,每半年进行一次牛奶摄入量和过敏反应发生情况的调查。采用生存分析评估反应风险与 OIT 维持方案依从性之间的关系。

结果

该队列包括 50 名患者。只有 56%的患者坚持了方案,即每周至少摄入 200 毫升牛奶至少 3 次。坚持治疗的患者发生过敏反应的风险显著降低,过敏反应、医疗/急诊就诊以及肾上腺素/抗组胺药物治疗的发生率也降低。

结论

研究结果表明,在食物过敏管理中,持续摄入维持剂量非常重要,定期摄入牛奶有助于保持无反应性并降低过敏症状的风险。

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