PMID- 20522461
OWN - NLM
STAT- MEDLINE
DCOM- 20110408
LR  - 20150708
IS  - 1468-2044 (Electronic)
IS  - 0003-9888 (Linking)
VI  - 96
IP  - 3
DP  - 2011 Mar
TI  - Specific oral tolerance induction in food allergic children: is oral 
      desensitisation more effective than allergen avoidance?: a meta-analysis of 
      published RCTs.
PG  - 259-64
LID - 10.1136/adc.2009.172460 [doi]
AB  - OBJECTIVE: To determine whether specific oral tolerance induction (SOTI) is more 
      effective than avoidance in inducing tolerance in children aged 0-18 years who 
      have immunoglobulin E (IgE)-mediated food allergy. DATA SOURCES: MEDLINE (1950 to 
      July 2009), EMBASE (1980 to July 2009) and all EBM Reviews: Cochrane Database of 
      Systematic Reviews, ACP Journal Club, Database of Abstracts of Reviews of 
      Effects, Cochrane Methodology Register, Health Technology Assessment and NHS 
      Economic Evaluation Database (from start date to November 2008). The online table 
      of contents (November 2003 to July 2009) of the Journal of Allergy and Clinical 
      Immunology, Pediatric Allergy and Immunology and Allergy were also searched, and 
      reference lists of retrieved articles were scrutinised for relevant studies. 
      STUDY SELECTION: Randomised controlled trials (RCT) were included providing they 
      enrolled children with IgE-mediated food allergy diagnosed using the criterion 
      standard tool (double-blind placebo-controlled food challenge) before 
      randomisation and also compared posttreatment tolerance between groups using the 
      criterion standard measures. RESULTS: Three studies met the inclusion criteria, 
      and two proved a statistically significant reduction in endpoint allergy 
      (determined by oral food challenge) after SOTI compared with the control. The 
      meta-analysis of the included studies found a lower RR of allergy after SOTI, but 
      this did not meet statistical significance (0.606783; 95% CI 0.317733 to 
      1.158791). CONCLUSIONS: SOTI cannot yet be recommended in routine practice as a 
      means to induce tolerance in children with IgE-mediated food allergy. Further 
      research is needed using large, high-quality RCT that investigate a variety of 
      food allergens and assesses the long-term efficacy, safety and cost-effectiveness 
      of SOTI.
FAU - Fisher, H R
AU  - Fisher HR
AD  - Division of Asthma, Allergy and Lung Biology, MRC and Asthma UK Centre in 
      Allergic Mechanisms of Asthma, Guy's and St Thomas' NHS Foundation Trust, King's 
      College London, London, UK. Helen.r.fisher@kcl.ac.uk
FAU - du Toit, G
AU  - du Toit G
FAU - Lack, G
AU  - Lack G
LA  - eng
GR  - Department of Health/United Kingdom
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20100603
PL  - England
TA  - Arch Dis Child
JT  - Archives of disease in childhood
JID - 0372434
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Desensitization, Immunologic/*methods
MH  - Food Hypersensitivity/immunology/prevention & control/*therapy
MH  - Humans
MH  - Immune Tolerance
MH  - Immunoglobulin E/immunology
MH  - Infant
MH  - Infant, Newborn
MH  - Randomized Controlled Trials as Topic
EDAT- 2010/06/05 06:00
MHDA- 2011/04/09 06:00
CRDT- 2010/06/05 06:00
PHST- 2010/06/05 06:00 [entrez]
PHST- 2010/06/05 06:00 [pubmed]
PHST- 2011/04/09 06:00 [medline]
AID - adc.2009.172460 [pii]
AID - 10.1136/adc.2009.172460 [doi]
PST - ppublish
SO  - Arch Dis Child. 2011 Mar;96(3):259-64. doi: 10.1136/adc.2009.172460. Epub 2010 
      Jun 3.