Adverse effects during specific oral tolerance induction: in home phase. 2012

Allergol Immunopathol (Madr). 2012 Jan-Feb;40(1):41-50. doi: 10.1016/j.aller.2011.05.004. Epub 2011 Jul 29.

Adverse effects during specific oral tolerance induction: in home phase.

Abstract

BACKGROUND:

Specific oral tolerance induction (SOTI) is a promising approach for severe food allergies. There are little data in the literature regarding the home-phase of SOTI, not only with regard to type and frequency of adverse reactions but also regarding the most suitable treatment and protocol.

AIMS:

To define the incidence and severity of adverse reactions, possible risk factors, and the safety and effectiveness of the home-phase of an original SOTI protocol in a large group of children with severe cow’s milk (CM) allergy, after the hospital “rush” phase.

METHODS:

The study was conducted by recording in-home phase adverse events, success and failure as reported by parents, and calling families. Adverse reactions were treated following the International Guidelines, arbitrarily modified by introducing nebulised epinephrine for respiratory reactions, oral beclomethasone for acute gastric pain and oral cromolyn for recurrent gastric pain.

RESULTS:

Out of 140 patients, 132 were contacted; eight were inaccessible (follow-up 2-84 months). The number of adverse reactions was 1 in every 100 doses. The reactions were treated with nebulised epinephrine (221 reactions), IM epinephrine (6 reactions), and other drugs. Patients with high specific IgE levels (greater than 100 kU(A)/L) and lower CM dose (less than 5 ml) at the end of in-hospital phase showed a higher risk both for number of reactions and use of nebulised epinephrine.

CONCLUSIONS:

The home phase of SOTI was characterised by a significant number of adverse reactions, mostly managed with an acceptable rate of side effects. Nebulised epinephrine played a pivotal role in respiratory reactions.

Copyright © 2011 SEICAP. Published by Elsevier Espana. All rights reserved.

LINK TO: Adverse effects during specific oral tolerance induction: in home phase. Allergologia et Immunopathologia. 40(1):41-50, 2012 Jan-Feb.

http://www.ncbi.nlm.nih.gov/pubmed/21802824

Site created by Food Allergy Parents like YOU ! … They said there were NO TREATMENTS for food allergy!