Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Allergy, Asthma & Clinical Immunology
Published in: Allergy, Asthma & Clinical Immunology 1/2014

Open Access 01-12-2014 | Research

Multiple-allergen oral immunotherapy improves quality of life in caregivers of food-allergic pediatric subjects

Authors: Iris M Otani, Philippe Bégin, Clare Kearney, Tina LR Dominguez, Anjuli Mehrotra, Liane R Bacal, Shruti Wilson, Kari Nadeau

Published in: Allergy, Asthma & Clinical Immunology | Issue 1/2014

Login to get access

Abstract

Background

Food allergy (FA) negatively affects quality of life in caregivers of food-allergic children, imposing a psychosocial and economic burden. Oral immunotherapy (OIT) is a promising investigational therapy for FA. However, OIT can be a source of anxiety as it carries risk for allergic reactions. The effect of OIT with multiple food allergens (mOIT) on FA-specific health-related quality of life (HRQL) has never been studied in participants with multiple, severe food allergies. This study is the first to investigate the effects of mOIT on FA-related HRQL in caregivers of pediatric subjects.

Methods

Caregiver HRQL was assessed using a validated Food Allergy Quality of Life – Parental Burden (FAQL-PB) Questionnaire (J Allergy Clin Immunol 114(5):1159-1163, 2004). Parents of participants in two single-center Phase I clinical trials receiving mOIT (n = 29) or rush mOIT with anti-IgE (omalizumab) pre-treatment (n = 11) completed the FAQL-PB prior to study intervention and at 2 follow-up time-points (6 months and 18 months). Parents of subjects not receiving OIT (control group, n = 10) completed the FAQL-PB for the same time-points.

Results

HRQL improved with clinical (change < -0.5) and statistical (p < 0.05) significance in the mOIT group (baseline mean 3.9, 95% CI 3.4-4.4; 6-month follow-up mean 2.5, 95% CI 2.0-3.0; 18-month follow-up mean 1.8, 95% CI 1.4-2.1) and rush mOIT group (baseline mean 3.9, 95% CI 3.1-4.7; 6-month follow-up mean 1.7, 95% CI 0.9-2.6; 18-month follow-up mean 1.3, 95% CI 0.3-2.4). HRQL scores did not significantly change in the control group (n = 10).

Conclusion

Multi-allergen OIT with or without omalizumab leads to improvement in caregiver HRQL, suggesting that mOIT can help relieve the psychosocial and economic burden FA imposes on caregivers of food-allergic children.
Appendix
Available only for authorised users
Literature
1.
Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, Holl JL: The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics. 2011, 128 (1): e9-e17. 10.1542/peds.2011-0204.CrossRefPubMed
2.
Soller L, Ben-Shoshan M, Harrington DW, Fragapane J, Joseph L, St Pierre Y, Godefroy SB, La Vieille S, Elliott SJ, Clarke AE: Overall prevalence of self-reported food allergy in Canada. J Allergy Clin Immunol. 2012, 130 (4): 986-988. 10.1016/j.jaci.2012.06.029.CrossRefPubMed
3.
Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad SH, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons FE, Teach SJ, Yawn BP, Schwaninger JM: NIAID-Sponsored Expert Panel: Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010, 126 (6s): S1-S58.PubMedCentralPubMed
4.
Lieberman JA, Sicherer SH: Quality of life in food allergy. Curr Opin Allergy Clin Immunol. 2011, 11 (3): 236-242. 10.1097/ACI.0b013e3283464cf0.CrossRefPubMed
5.
Sicherer SH, Noone SA, Munoz-Furlong A: The impact of childhood food allergy on quality of life. Ann Allergy Asthma Immunol. 2001, 87 (6): 461-464. 10.1016/S1081-1206(10)62258-2.CrossRefPubMed
6.
Avery NJ, King RM, Knight S, Hourihane JO: Assessment of quality of life in children with peanut allergy. Pediatr Allergy Immunol. 2003, 14 (5): 378-382. 10.1034/j.1399-3038.2003.00072.x.CrossRefPubMed
7.
Gupta R, Holdford D, Bilaver L, Dyer A, Holl JL, Meltzer D: The economic impact of childhood food allergy in the United States. JAMA Pediatrics. 2013, 167 (11): 1026-1031. 10.1001/jamapediatrics.2013.2376.CrossRefPubMed
8.
Cohen BL, Noone S, Munoz-Furlong A, Sicherer SH: Development of a questionnaire to measure quality of life in families with a child with food allergy. J Allergy Clin Immunol. 2004, 114 (5): 1159-1163. 10.1016/j.jaci.2004.08.007.CrossRefPubMed
9.
Christie L, Hine RJ, Parker JG, Burks W: Food allergies in children affect nutrient intake and growth. J Am Diet Assoc. 2002, 102 (11): 1648-1651. 10.1016/S0002-8223(02)90351-2.CrossRefPubMed
10.
Savage JH, Matsui EC, Skripak JM, Wood RA: The natural history of egg allergy. J Allergy Clin Immunol. 2007, 120 (6): 1413-1417. 10.1016/j.jaci.2007.09.040.CrossRefPubMed
11.
Nadeau KC, Kohli A, Iyengar S, DeKruyff RH, Umetsu DT: Oral immunotherapy and anti-IgE antibody-adjunctive treatment for food allergy. Immunol Allergy Clin North Am. 2012, 32 (1): 111-133. 10.1016/j.iac.2011.11.004.CrossRefPubMed
12.
Begin P, Winterroth LC, Dominguez T, Wilson SP, Bacal L, Mehrotra A, Kausch B, Trela A, Hoyte E, O’Riordan G, Seki S, Blakemore A, Woch M, Hamilton RG, Nadeau KC: Safety and feasibility of oral immunotherapy to multiple allergens for food allergy. Allergy Asthma Clin Immunol. 2014, 10 (1): 1-10.1186/1710-1492-10-1.PubMedCentralCrossRefPubMed
13.
Begin P, Dominguez T, Wilson SP, Bacal L, Mehrotra A, Kausch B, Trela A, Travassoli M, Hoyte E, O’Riordan G, Blakemore A, Seki S, Hamilton RG, Nadeau KC: Phase 1 results of safety and tolerability in a rush oral immunotherapy protocol to multiple foods using Omalizumab. Allergy Asthma Clin Immunol. 2014, 10 (1): 2-10.1186/1710-1492-10-2.CrossRef
14.
Flokstra-de Blok BM, van der Velde JL, Vlieg-Boerstra BJ, Oude Elberink JN, DunnGalvin A, Hourihane JO, Duiverman EJ, Dubois AE: Health-related quality of life of food allergic patients measured with generic and disease-specific questionnaires. Allergy. 2010, 65 (8): 1031-1038. 10.1111/j.1398-9995.2009.02304.x.CrossRefPubMed
15.
Flokstra-de Blok BM, Dubois AE: Quality of life measures for food allergy. Clin Exp Allergy. 2012, 42 (7): 1014-1020. 10.1111/j.1365-2222.2011.03927.x.CrossRefPubMed
16.
LeBovidge JS, Haskell H, Borras I, Hoyte E, Umetsu DT, Nadeau KC, Schneider LC: Patient and parent perspectives on quality of life during participation in a study of rapid oral desensitization with omalizumab therapy in patients with milk allergy. J Allergy Clin Immunol. 2012, 129 (2): AB30-CrossRef
17.
Factor JM, Mendelson L, Lee J, Nouman G, Lester MR: Effect of oral immunotherapy to peanut on food-specific quality of life. Ann Allergy Asthma Immunol. 2012, 109 (5): 348-352. 10.1016/j.anai.2012.08.015. e342CrossRefPubMed
18.
Carraro S, Frigo AC, Perin M, Stefani S, Cardarelli C, Bozzetto S, Baraldi E, Zanconato S: Impact of oral immunotherapy on quality of life in children with cow milk allergy: a pilot study. Int J Immunopathol Pharmacol. 2012, 25 (3): 793-798.PubMed
19.
DunnGalvin A, Cullinane C, Daly DA, Flokstra-de Blok BM, Dubois AE, Hourihane JO: Longitudinal validity and responsiveness of the food allergy quality of life questionnaire - parent form in children 0–12 years following positive and negative food challenges. Clin Exp Allergy. 2010, 40 (3): 476-485. 10.1111/j.1365-2222.2010.03454.x.CrossRefPubMed
20.
Kocks JW, Tuinenga MG, Uil SM, van den Berg JW, Stahl E, van der Molen T: Health status measurement in COPD: the minimal clinically important difference of the clinical COPD questionnaire. Respir Res. 2006, 7: 62-10.1186/1465-9921-7-62.PubMedCentralCrossRefPubMed
21.
Juniper EF, Guyatt GH, Willan A, Griffith LE: Determining a minimal important change in a disease-specific quality of life questionnaire. J Clin Epidemiol. 1994, 47 (1): 81-87. 10.1016/0895-4356(94)90036-1.CrossRefPubMed
22.
Deyo RA, Diehr P, Patrick DL: Reproducibility and responsiveness of health status measures: statistics and strategies for evaluation. Control Clin Trials. 1991, 12 (4s): 142S-158S.CrossRefPubMed
23.
Jaeschke R, Singer J, Guyatt GH: Measurement of health status: ascertaining the minimal clinically important difference. Control Clin Trials. 1989, 10 (4): 407-415. 10.1016/0197-2456(89)90005-6.CrossRefPubMed
24.
van der Velde JL, Flokstra-de Blok BM, de Groot H, Oude-Elberink JN, Kerkhof M, Duiverman EJ, Dubois AE: Food allergy-related quality of life after double-blind, placebo-controlled food challenges in adults, adolescents, and children. J Allergy Clin Immunol. 2012, 130 (5): 1136-1143. 10.1016/j.jaci.2012.05.037. e1132CrossRefPubMed
25.
Guyatt GH, Juniper EF, Walter SD, Griffith LE, Goldstein RS: Interpreting treatment effects in randomised trials. BMJ. 1998, 316 (7132): 690-693. 10.1136/bmj.316.7132.690.PubMedCentralCrossRefPubMed
26.
Burks AW, Jones SM, Wood RA, Fleischer DM, Sicherer SH, Lindblad RW, Stablein D, Henning AK, Vickery BP, Liu AH, Scurlock AM, Shreffler WG, Plaut M, Sampson HA, Consortium of Food Allergy Research (CoFAR): Oral immunotherapy for treatment of egg allergy in children. N Engl J Med. 2012, 367 (3): 233-243. 10.1056/NEJMoa1200435.PubMedCentralCrossRefPubMed
27.
Wasserman RL, Factor JM, Baker JW, Mansfield LE, Katz Y, Hague AR, Paul MM, Sugerman RW, Lee JO, Lester MR, Mendelson LM, Nacshon L, Levy MB, Goldberg MR, Elizur A: Oral immunotherapy for peanut allergy: multipractice experience with epinephrine-treated reactions. J Allergy Clin Immunol Pract. 2014, 2 (1): 91-96. 10.1016/j.jaip.2013.10.001.CrossRefPubMed
28.
Baptist AP, Dever SI, Greenhawt MJ, Polmear-Swendris N, McMorris MS, Clark NM: A self-regulation intervention can improve quality of life for families with food allergy. J Allergy Clin Immunol. 2012, 130 (1): 263-265. 10.1016/j.jaci.2012.03.029. e266CrossRefPubMed
Metadata
Title
Multiple-allergen oral immunotherapy improves quality of life in caregivers of food-allergic pediatric subjects
Authors
Iris M Otani
Philippe Bégin
Clare Kearney
Tina LR Dominguez
Anjuli Mehrotra
Liane R Bacal
Shruti Wilson
Kari Nadeau
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Allergy, Asthma & Clinical Immunology / Issue 1/2014
Electronic ISSN: 1710-1492
DOI
https://doi.org/10.1186/1710-1492-10-25

Other articles of this Issue 1/2014

Allergy, Asthma & Clinical Immunology 1/2014 Go to the issue

Research

Effect of ketotifen premedication on adverse reactions during peanut oral immunotherapy

Research

The changes and its significance of Th17 and Treg cells and related cytokines in patients with tuberculosis pleurisy

Research

Auto-injector needle length may be inadequate to deliver epinephrine intramuscularly in women with confirmed food allergy

Research

Enhancement of OVA-induced murine lung eosinophilia by co-exposure to contamination levels of LPS in Asian sand dust and heated dust

Research

Reasons for prescribing second generation antihistamines to treat allergic rhinitis in real-life conditions and patient response

Research

The efficacy and safety of the Timothy grass allergy sublingual immunotherapy tablet in Canadian adults and children