PMID- 34623772
OWN - NLM
STAT- MEDLINE
DCOM- 20220404
LR  - 20220405
IS  - 2050-4527 (Electronic)
IS  - 2050-4527 (Linking)
VI  - 10
IP  - 1
DP  - 2022 Jan
TI  - Omalizumab effectiveness in patients with a previously failed oral immunotherapy 
      for severe milk allergy.
PG  - 117-120
LID - 10.1002/iid3.542 [doi]
AB  - BACKGROUND: Some studies addressed the issue of omalizumab (OML) effectiveness in 
      children starting their first oral immunotherapy (OIT) attempt but no study 
      investigated the possible role of OML in the setting of patients with persisting 
      milk allergy after a failed OIT attempt. METHODS: Single-center, prospective, 
      observational study in a selected group of patients with a persisting and severe 
      cow milk (CM) allergy associated with moderate allergic asthma, in which a 
      previous OIT attempt had already failed. We performed an open oral food challenge 
      (OFC) to identify patients who tolerated less than 173 mg of cow's milk protein. 
      At the end of the recruitment, we have found four patients with a mean age of 
      16.25 years (8-24) who had suspended a previous OIT attempt and still reacted to 
      an amount of CM equal or below 173 mg. Enrolled patients, after an 8-week course 
      of OML along with a CM avoiding diet, underwent again an open OFC with CM to 
      re-evaluate their threshold. Eventually, a new OIT course was started using the 
      same OIT protocol of the previous attempt, maintaining cotreatment with OML for 
      the first 12 months. For each patient, we documented: the threshold of CM at OFC, 
      level of specific immunoglobulin E (IgE) and IgG4 for milk, and quality of life 
      (QoL). RESULTS: During OIT the four patients experienced no reactions or 
      extremely mild ones (oral itching, transient mild abdominal pain). All increased 
      their threshold of CM in OML if compared with the baseline and maintained it long 
      after that biologic therapy had discontinued. Specific milk proteins IgG4 levels 
      significantly increased in all. CONCLUSION: In this series, OML was effective in 
      patients with severe CM allergy who had previously failed OIT, allowing milk 
      intake without adverse reactions and improving the QoL.
CI  - (c) 2021 The Authors. Immunity, Inflammation and Disease published by John Wiley & 
      Sons Ltd.
FAU - Badina, Laura
AU  - Badina L
AD  - Clinica Pediatrica, Institute for Maternal and Child Health - "IRCCS Burlo 
      Garofolo", Trieste, Italy.
FAU - Belluzzi, Beatrice
AU  - Belluzzi B
AD  - Department of Medical Sciences, University of Trieste, Trieste, Italy.
FAU - Contorno, Sarah
AU  - Contorno S
AD  - Department of Medical Sciences, University of Trieste, Trieste, Italy.
FAU - Bossini, Benedetta
AU  - Bossini B
AD  - Department of Medical Sciences, University of Trieste, Trieste, Italy.
FAU - Benelli, Elisa
AU  - Benelli E
AD  - Department of Medical Sciences, University of Trieste, Trieste, Italy.
FAU - Barbi, Egidio
AU  - Barbi E
AUID- ORCID: 0000-0002-6343-846X
AD  - Clinica Pediatrica, Institute for Maternal and Child Health - "IRCCS Burlo 
      Garofolo", Trieste, Italy.
AD  - Department of Medical Sciences, University of Trieste, Trieste, Italy.
FAU - Berti, Irene
AU  - Berti I
AD  - Clinica Pediatrica, Institute for Maternal and Child Health - "IRCCS Burlo 
      Garofolo", Trieste, Italy.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20211008
PL  - England
TA  - Immun Inflamm Dis
JT  - Immunity, inflammation and disease
JID - 101635460
RN  - 2P471X1Z11 (Omalizumab)
SB  - IM
MH  - Administration, Oral
MH  - Animals
MH  - Cattle
MH  - Desensitization, Immunologic/methods
MH  - Female
MH  - Humans
MH  - Milk/adverse effects
MH  - *Milk Hypersensitivity/therapy
MH  - Omalizumab/therapeutic use
MH  - Prospective Studies
MH  - Quality of Life
PMC - PMC8669684
OTO - NOTNLM
OT  - IgE-mediated food allergies
OT  - IgE-mediated reactions
OT  - OIT failure
OT  - anaphylaxis
OT  - asthma
OT  - avoidance diet
OT  - omalizumab
OT  - oral immunotherapy
OT  - severe milk allergy
COIS- The authors declare that there are no conflict of interests.
EDAT- 2021/10/09 06:00
MHDA- 2022/04/05 06:00
PMCR- 2021/10/08
CRDT- 2021/10/08 12:35
PHST- 2021/09/21 00:00 [revised]
PHST- 2021/08/26 00:00 [received]
PHST- 2021/09/22 00:00 [accepted]
PHST- 2021/10/09 06:00 [pubmed]
PHST- 2022/04/05 06:00 [medline]
PHST- 2021/10/08 12:35 [entrez]
PHST- 2021/10/08 00:00 [pmc-release]
AID - IID3542 [pii]
AID - 10.1002/iid3.542 [doi]
PST - ppublish
SO  - Immun Inflamm Dis. 2022 Jan;10(1):117-120. doi: 10.1002/iid3.542. Epub 2021 Oct 
      8.