• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Clinical and experimental allergy : >Safety and predictors of adverse events during oral immunotherapy for milk allergy: Severity of reaction at oral challenge, specific IgE and prick test
【24h】

Safety and predictors of adverse events during oral immunotherapy for milk allergy: Severity of reaction at oral challenge, specific IgE and prick test

机译：口服免疫疗法对牛奶过敏的不良反应的安全性和预测因素：口服攻击时的反应严重程度，特异性IgE和点刺试验

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: Strict avoidance is the only accepted management for cow's milk (CM) allergy. CM oral immunotherapy (CM-OIT) is under investigation. Objectives: To evaluate long-term safety of CM-OIT. To identify clinical/immunological predictors of adverse events. Methods: Prospective longitudinal epidemiological intervention study. CM-allergic children aged 5-18 underwent a Spanish-approved CM-OIT protocol without premedication. Clinical data, skin prick test (SPT) and specific IgE (sIgE) at baseline and 1 year after OIT were registered. All dose-related reactions, treatments needed and cofactors involved were recorded. Through survival analysis, we studied the cumulative probability of reactions resolution over time and clinical/immunological risk factors of reactions persistence. Results: 81 children were recruited. Mean follow-up was 25 months. 95% of children suffered reactions, 91% of which affected a single organ. Reactions were heterogeneously distributed: (a) 60 children (75%) had occasional symptoms which ceased over time. 86% of them reached complete desensitization (200 mL). (b) 20 children (25%) suffered frequent (78% of total reactions), more severe and unpredictable reactions, which persisted during follow-up or led to withdrawal (6 cases). Reactions persistence was associated with a higher frequency and severity. Kaplan-Meier estimate revealed a cumulative probability of reactions resolution of 25% at 3 months (95% CI: 1.9-4.1) and 50% (95% CI: 6.1-9.9) at 8 months based on all patients. Cox proportional hazards multivariate regression model identified 3 variables (CM-sIgE ≥ 50 KU L-1, CM-SPT ≥ 9 mm and Sampson's severity grades 2, 3 and 4 at baseline food challenge) as independent risk factors of reactions persistence. The combination of 2 or 3 of these factors involved hazard ratios to develop persistent reactions of 2.26 (95% CI: 1.14-4.46; P = 0.019) and 6.06 (95% CI: 2.7-13.7; P 0.001), respectively. Clinical implications: CM-OIT was insufficiently safe in 25% of children. The above-mentioned clinical and immunological parameters would help clinicians to identify highly reactive patients before CM-OIT. In them, individualized schedules and premedication should be considered.
机译：背景：严格避免是唯一接受的牛奶（CM）过敏治疗方法。 CM口服免疫疗法（CM-OIT）正在研究中。目的：评估CM-OIT的长期安全性。识别不良事件的临床/免疫预测因素。方法：前瞻性纵向流行病学干预研究。 5至18岁的CM过敏儿童接受了西班牙批准的CM-OIT方案，且未进行预先用药。记录基线和OIT后1年的临床数据，皮肤点刺试验（SPT）和特异性IgE（sIgE）。记录所有与剂量有关的反应，所需的治疗和涉及的辅因子。通过生存分析，我们研究了随着时间推移反应解决的累积概率以及反应持续性的临床/免疫危险因素。结果：招募了81名儿童。平均随访时间为25个月。 95％的儿童有反应，其中91％影响单个器官。反应是异质性分布的：（a）60名儿童（75％）偶尔出现症状，并随着时间的流逝而消失。其中86％达到完全脱敏（200 mL）。 （b）20名儿童（25％）经常发生（占总反应的78％），反应更为严重和不可预测，在随访期间持续存在或导致戒断（6例）。反应持续性与更高的频率和严重性相关。 Kaplan-Meier估计显示，基于所有患者，在3个月时反应消退的累积概率为25％（95％CI：1.9-4.1），在8个月时为50％（95％CI：6.1-9.9）。 Cox比例风险多元回归模型确定了3个变量（基线食物挑战时CM-sIgE≥50 KU L-1，CM-SPT≥9 mm和Sampson的严重度等级为2、3和4）作为反应持续性的独立危险因素。这些因素中的2或3个因素的组合涉及的危险比分别导致持续反应分别为2.26（95％CI：1.14-4.46; P = 0.019）和6.06（95％CI：2.7-13.7; P <0.001）。临床意义：CM-OIT在25％的儿童中不够安全。上述临床和免疫学参数将有助于临床医生在CM-OIT之前识别高反应性患者。在他们中，应考虑个性化的时间表和处方药。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号