PMID- 30685892 OWN - NLM STAT- MEDLINE DCOM- 20190612 LR - 20190613 IS - 1399-3038 (Electronic) IS - 0905-6157 (Linking) VI - 30 IP - 3 DP - 2019 May TI - Outcome of oral immunotherapy for persistent cow's milk allergy from 11 years of experience in Finland. PG - 356-362 LID - 10.1111/pai.13025 [doi] AB - BACKGROUND: The safety and efficacy of long-term milk oral immunotherapy (OIT) in Finnish children with persistent cow's milk allergy (CMA) were evaluated in an open-label, non-randomized study. METHODS: During the 11-year study, 296 children aged 5 years or older with immunoglobulin E (IgE)-mediated CMA started milk OIT. Follow-up data were collected at three time points: the post-buildup phase, 1 year thereafter, and at the cross-sectional long-term follow-up between January 2016 and December 2017. Patients were divided according to baseline milk-specific IgE (sIgE) level and by the amount of milk consumption at the long-term follow-up. The high-dose group consumed >/=2 dL of milk daily, while the failure group consumed <2 dL of milk or were on a milk-avoidance diet. RESULTS: Out of the initial study group, 244/296 (83%) patients participated in the long-term follow-up. Among these patients, 136/244 (56%) consumed >/=2 dL of milk daily. The median follow-up time was 6.5 years. Of the recorded markers and clinical factors, the baseline milk sIgE level was most associated with maintaining milk OIT (P < 0.001). Respiratory symptoms in the post-buildup phase increased the risk of treatment failure (OR 3.5, 95% CI: 1.5-8.1, P = 0.003) and anaphylaxis (OR 14.3, 95% CI: 1.8-114, P = 0.01). CONCLUSION: More than half of the patients were able to maintain the targeted milk dose in their daily diet. Baseline milk sIgE level and reactivity during the early treatment stage strongly predicted the long-term outcome and safety of milk OIT. CI - (c) 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd. FAU - Kauppila, Tiina Kaisa AU - Kauppila TK AUID- ORCID: 0000-0001-8254-8608 AD - University of Helsinki, Helsinki, Finland. AD - Helsinki University Hospital, Skin and Allergy Hospital, Helsinki, Finland. FAU - Paassilta, Marita AU - Paassilta M AD - Allergy Center, Tampere University Hospital, Tampere, Finland. FAU - Kukkonen, Anna Kaarina AU - Kukkonen AK AD - Helsinki University Hospital, Skin and Allergy Hospital, Helsinki, Finland. FAU - Kuitunen, Mikael AU - Kuitunen M AD - Children's Hospital, University of Helsinki, Helsinki, Finland. FAU - Pelkonen, Anna S AU - Pelkonen AS AD - Helsinki University Hospital, Skin and Allergy Hospital, Helsinki, Finland. FAU - Makela, Mika J AU - Makela MJ AD - Helsinki University Hospital, Skin and Allergy Hospital, Helsinki, Finland. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20190218 PL - England TA - Pediatr Allergy Immunol JT - Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology JID - 9106718 RN - 37341-29-0 (Immunoglobulin E) SB - IM MH - Administration, Oral MH - Adolescent MH - Animals MH - Child MH - Child, Preschool MH - Cross-Sectional Studies MH - Female MH - Finland MH - Follow-Up Studies MH - Humans MH - Immunoglobulin E/blood MH - Immunotherapy/adverse effects/*methods MH - Male MH - Milk/*immunology MH - Milk Hypersensitivity/immunology/*therapy MH - Treatment Outcome OTO - NOTNLM OT - IgE OT - children OT - desensitization OT - food allergy OT - milk allergy OT - oral immunotherapy OT - prognosis EDAT- 2019/01/28 06:00 MHDA- 2019/06/14 06:00 CRDT- 2019/01/28 06:00 PHST- 2018/06/14 00:00 [received] PHST- 2018/12/20 00:00 [revised] PHST- 2019/01/15 00:00 [accepted] PHST- 2019/01/28 06:00 [pubmed] PHST- 2019/06/14 06:00 [medline] PHST- 2019/01/28 06:00 [entrez] AID - 10.1111/pai.13025 [doi] PST - ppublish SO - Pediatr Allergy Immunol. 2019 May;30(3):356-362. doi: 10.1111/pai.13025. Epub 2019 Feb 18.