Milk oral immunotherapy is effective in school-aged children

Area of Science:

• Pediatric Allergy and Immunology
• Clinical Immunology
• Food Allergy Research

Background:

• Cow's milk allergy (CMA) is a common food allergy in children.
• Oral immunotherapy (OIT) is a potential treatment strategy for food allergies.
• Establishing the efficacy and long-term outcomes of OIT in pediatric CMA is crucial.

Purpose of the Study:

• To evaluate the effectiveness of oral immunotherapy (OIT) in desensitizing schoolchildren diagnosed with cow's milk allergy (CMA).
• To assess the sustained tolerance to cow's milk products following OIT in a pediatric population.

Main Methods:

• A randomized, double-blind, placebo-controlled trial involving 28 children (aged 6-14 years) with confirmed CMA.
• Gradual escalation of cow's milk protein intake over 23 weeks, from 0.06 mg to 6400 mg daily.
• Follow-up assessments at 12 months and 3-3.5 years post-OIT to determine sustained tolerance.

Main Results:

• Twenty-four participants (86%) completed the study protocol.
• Significant desensitization was observed, with most participants in the active OIT group tolerating daily milk consumption.
• After completing the placebo phase, all children in the placebo group successfully underwent open-label OIT and tolerated daily milk intake.
• Long-term follow-up indicated a sustained success rate of 79% (22/28) for daily milk consumption over 3-3.5 years.

Conclusions:

• This placebo-controlled, double-blind study demonstrates the efficacy of OIT in achieving desensitization in schoolchildren with CMA.
• The desensitization achieved through OIT is generally sustained for over three years, with few exceptions.
• OIT represents a viable therapeutic option for managing pediatric CMA, offering long-term tolerance to milk products.