ID | 61149 |
フルテキストURL | |
著者 |
Ogura, Kiyotake
Department of Pediatrics, National Hospital Organization, Sagamihara National Hospital
Yanagida, Noriyuki
Department of Pediatrics, National Hospital Organization, Sagamihara National Hospital
Sato, Sakura
Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine
Imai, Takanori
Department of Pediatrics, Showa University School of Medicine
Ito, Komei
Department of Allergy, Aichi Children's Health and Medical Center
Kando, Naoyuki
Department of Allergy, Aichi Children's Health and Medical Center
Ikeda, Masanori
Department of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kaken ID
publons
researchmap
Shibata, Rumiko
Department of Pediatrics, National Hospital Organization, Fukuoka National Hospital
Murakami, Yoko
Department of Pediatrics, National Hospital Organization, Fukuoka National Hospital
Fujisawa, Takao
Institute for Clinical Research, National Hospital Organization, Mie National Hospital
Nagao, Mizuho
Institute for Clinical Research, National Hospital Organization, Mie National Hospital
Kawamoto, Norio
Department of Pediatrics, Graduate School of Medicine, Gifu University
Kondo, Naomi
Department of Pediatrics, Graduate School of Medicine, Gifu University
Urisu, Atsuo
Department of Pediatrics, Fujita Health University, The Second Teaching Hospital
Tsuge, Ikuya
Department of Pediatrics, Fujita Health University, The Second Teaching Hospital
Kondo, Yasuto
Department of Pediatrics, Fujita Health University, The Second Teaching Hospital
Sugai, Kazuko
Department of Pediatrics, National Hospital Organization, Yokohama Medical Center
Uchida, Osamu
Department of Pediatrics, National Hospital Organization, Yokohama Medical Center
Urashima, Mitsuyoshi
Division of Molecular Epidemiology, The Jikei University School of Medicine
Taniguchi, Masami
Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine
Ebisawa, Motohiro
Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine
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抄録 | Background
Generally, oral immunotherapy (OIT) aims for daily administration. Recently, the efficacy of treatment with OIT at a low dose has been reported. However, the optimal dose and the evaluation of dose-dependent OIT outcome have not been described.
Methods
A multicenter, parallel, open-labeled, prospective, non-placebo controlled, randomized study enrolled 101 Japanese patients for treatment with OIT. We hypothesized that target dose OIT would induce short-term unresponsiveness (StU) earlier than reduced dose OIT. StU was defined as no response to 6200 mg whole egg, 3400 mg milk, and 2600 mg wheat protein, as evaluated by oral food challenge after 2-week ingestion cessation. To compare the two doses of OIT efficacy, the maximum ingestion doses during the maintenance phase of OIT were divided into 100%-dose or 25%-dose groups against their target StU dose, respectively. A total of 51 patients were assigned to the 100%-dose group [hen's egg (HE) = 26, cow's milk (CM) = 13, wheat = 12] and 50 to the 25%-dose group (HE = 25, CM = 13, wheat = 12). Primary outcome was established by comparing StU at 1 year. Secondary outcome was StU at 2 years and established by comparing allergic symptoms and immunological changes.
Results
The year 1 StU rates (%) for the 100%- and 25%-dose groups were 26.9 vs. 20.0 (HE), 7.7 vs. 15.4 (CM), and 50.0 vs. 16.7 (wheat), respectively. The year 2 StU rates were 30.8 vs. 36.0 (HE), 7.7 vs. 23.1 (CM), and 58.3 vs. 58.3 (wheat), respectively. There were no statistically significant differences in StU between years 1 and 2. The total allergic symptom rate in the 25%-dose group was lower than that in the 100%-dose group for egg, milk, and wheat. Antigen-specific IgE levels for egg-white, milk, and wheat decreased at 12 months.
Conclusions
Reduced maintenance dose of egg OIT showed similar therapeutic efficacy to the target dose. However, we were not able to clearly demonstrate the efficacy, particularly for milk and wheat. Reducing the maintenance dose for eggs, milk, and wheat may effectively lower the symptoms associated with their consumption compared to the target OIT dose. Furthermore, aggressive reduction of the maintenance dose might be important for milk and wheat, compared to the 25%-dose OIT.
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キーワード | Food hypersensitivity
Immunotherapy
Dose-response relationship
Desensitization
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発行日 | 2020-10
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出版物タイトル |
World Allergy Organization Journal
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巻 | 13巻
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号 | 10号
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出版者 | Elsevier
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開始ページ | 100463
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ISSN | 1939-4551
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NCID | AA12582077
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資料タイプ |
学術雑誌論文
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言語 |
英語
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OAI-PMH Set |
岡山大学
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著作権者 | © 2020 The Authors.
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論文のバージョン | publisher
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PubMed ID | |
DOI | |
Web of Science KeyUT | |
関連URL | isVersionOf https://doi.org/10.1016/j.waojou.2020.100463
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ライセンス | http://creativecommons.org/licenses/by/4.0/
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