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Published in: Trials 1/2022

Open Access 01-12-2022 | Atopic Dermatitis | Study protocol

Tolerance induction through early feeding to prevent food allergy in infants with eczema (TEFFA): rationale, study design, and methods of a randomized controlled trial

Authors: Birgit Kalb, Lara Meixner, Valérie Trendelenburg, Nathalie Unterleider, Josefine Dobbertin-Welsch, Stephanie Heller, Sabine Dölle-Bierke, Stephanie Roll, Susanne Lau, Young-Ae Lee, Florent Fauchère, Julian Braun, Magda Babina, Sabine Altrichter, Till Birkner, Margitta Worm, Kirsten Beyer

Published in: Trials | Issue 1/2022

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Abstract

Background

Up to 8% of all children in industrialized countries suffer from food allergies, whereas children with atopic eczema are affected considerably more frequently. In addition, the type and starting time of weaning foods seem to influence the development of food allergies. However, data from interventional studies on weaning are controversial.
The aim of this randomized-controlled clinical trial is to investigate, whether an early introduction of hen's egg (HE), cow’s milk (CM), peanut (PN), and hazelnut (HN) in children with atopic eczema can reduce the risk for developing food allergies in the first year of life.

Methods

This is a protocol for a randomized, placebo controlled, double blind, single-center clinical trial.
One hundred fifty infants with atopic eczema at 4–8 months of age will be randomized in a 2:1 manner into an active group that will receive rusk-like biscuit powder with HE, CM, PN, and HN (initially approximately 2 mg of each food protein) for 6–8 months or a placebo group, whose participants will receive the same rusk-like biscuit powder without HE, CM, PN, and HN on a daily basis. During the interventional period, the amount of allergens in the study product will be increased three times, each after 6 weeks. All study participants who are sensitized to HE, CM, PN, or HN at the end of the interventional period will undergo an oral food challenge to the respective food in a further visit.
Primary endpoint is IgE-mediated food allergy to at least one of the four foods (HE, CM, PN or HN) after 6–8 months of intervention (i.e., at around 1 year of age). Secondary endpoints include multiple food allergies, severity of eczema, wheezing, and sensitization levels against food allergens.

Discussion

This clinical trial will assess whether an early introduction of allergenic foods into the diet of children with atopic eczema can prevent the development of food allergies. This trial will contribute to update food allergy prevention guidelines.

Trial registration

German Clinical Trials Register DRKS00016770. Registered on 09 January 2020.
Appendix
Available only for authorised users
Literature
9.
go back to reference Tham EH, Lee BW, Chan YH, Loo EXL, Toh JY, Goh A, et al. Low food allergy prevalence despite delayed introduction of allergenic foods-data from the GUSTO cohort. J Allergy Clin Immunol Pract. 2018;6(2):466–75.e1.CrossRef Tham EH, Lee BW, Chan YH, Loo EXL, Toh JY, Goh A, et al. Low food allergy prevalence despite delayed introduction of allergenic foods-data from the GUSTO cohort. J Allergy Clin Immunol Pract. 2018;6(2):466–75.e1.CrossRef
10.
go back to reference Bellach J, Schwarz V, Ahrens B, Trendelenburg V, Aksünger Ö, Kalb B, et al. Randomized placebo-controlled trial of hen’s egg consumption for primary prevention in infants. J Allergy Clin Immunol. 2017;139(5):1591–9.e2.CrossRef Bellach J, Schwarz V, Ahrens B, Trendelenburg V, Aksünger Ö, Kalb B, et al. Randomized placebo-controlled trial of hen’s egg consumption for primary prevention in infants. J Allergy Clin Immunol. 2017;139(5):1591–9.e2.CrossRef
11.
go back to reference Wei-Liang Tan J, Valerio C, Barnes EH, Turner PJ, Van Asperen PA, Kakakios AM, et al. A randomized trial of egg introduction from 4 months of age in infants at risk for egg allergy. J Allergy Clin Immunol. 2017;139(5):1621–8.e8.CrossRef Wei-Liang Tan J, Valerio C, Barnes EH, Turner PJ, Van Asperen PA, Kakakios AM, et al. A randomized trial of egg introduction from 4 months of age in infants at risk for egg allergy. J Allergy Clin Immunol. 2017;139(5):1621–8.e8.CrossRef
14.
go back to reference Perkin MR, Logan K, Marrs T, Radulovic S, Craven J, Flohr C, et al. Enquiring About Tolerance (EAT) study: feasibility of an early allergenic food introduction regimen. The Journal of allergy and clinical immunology. 2016;137(5):1477–86.e8.CrossRef Perkin MR, Logan K, Marrs T, Radulovic S, Craven J, Flohr C, et al. Enquiring About Tolerance (EAT) study: feasibility of an early allergenic food introduction regimen. The Journal of allergy and clinical immunology. 2016;137(5):1477–86.e8.CrossRef
23.
go back to reference Sampson HA, Gerth van Wijk R, Bindslev-Jensen C, Sicherer S, Teuber SS, Burks AW, et al. Standardizing double-blind, placebo-controlled oral food challenges: American Academy of Allergy, Asthma & Immunology-European Academy of Allergy and Clinical Immunology PRACTALL consensus report. J Allergy Clin Immunol. 2012;130(6):1260–74. https://doi.org/10.1016/j.jaci.2012.10.017.CrossRefPubMed Sampson HA, Gerth van Wijk R, Bindslev-Jensen C, Sicherer S, Teuber SS, Burks AW, et al. Standardizing double-blind, placebo-controlled oral food challenges: American Academy of Allergy, Asthma & Immunology-European Academy of Allergy and Clinical Immunology PRACTALL consensus report. J Allergy Clin Immunol. 2012;130(6):1260–74. https://​doi.​org/​10.​1016/​j.​jaci.​2012.​10.​017.CrossRefPubMed
24.
go back to reference Kelleher MM, Dunn-Galvin A, Gray C, Murray DM, Kiely M, Kenny L, et al. Skin barrier impairment at birth predicts food allergy at 2 years of age. J Allergy Clin Immunol. 2016;137(4):1111–6.e8.CrossRef Kelleher MM, Dunn-Galvin A, Gray C, Murray DM, Kiely M, Kenny L, et al. Skin barrier impairment at birth predicts food allergy at 2 years of age. J Allergy Clin Immunol. 2016;137(4):1111–6.e8.CrossRef
Metadata
Title
Tolerance induction through early feeding to prevent food allergy in infants with eczema (TEFFA): rationale, study design, and methods of a randomized controlled trial
Authors
Birgit Kalb
Lara Meixner
Valérie Trendelenburg
Nathalie Unterleider
Josefine Dobbertin-Welsch
Stephanie Heller
Sabine Dölle-Bierke
Stephanie Roll
Susanne Lau
Young-Ae Lee
Florent Fauchère
Julian Braun
Magda Babina
Sabine Altrichter
Till Birkner
Margitta Worm
Kirsten Beyer
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06126-x

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