To prospectively evaluate the effect of different dietary management strategies on the rate of acquisition of tolerance in children with cow's milk allergy (CMA). Otherwise healthy children (aged 1-12 months) diagnosed with CMA were prospectively evaluated. The study population was divided into 5 groups based upon the formula used for management: (1) extensively hydrolyzed casein formula ([EHCF], n = 55); (2) EHCF + Lactobacillus rhamnosus GG [LGG], n = 71); (3) hydrolyzed rice formula (RHF, n = 46); (4) soy formula (n = 55); and (5) amino acid based formula (n = 33). A food challenge was performed after 12 months to assess acquisition of tolerance. Two hundred sixty children were evaluated (167 male, 64.2%; age 5.92 months, 95% CI 5.48-6.37; body weight 6.66 kg, 95% CI 6.41-6.91; IgE-mediated CMA 111, 42.7%). The rate of children acquiring oral tolerance after 12 months was significantly higher (P < .05) in the groups receiving EHCF (43.6%) or EHCF + LGG (78.9%) compared with the other groups: RHF (32.6%), soy formula (23.6%), and amino acid based formula (18.2%). Binary regression analysis coefficient (B) revealed that the rate of patients acquiring tolerance at the end of the study was influenced by 2 factors: (1) IgE-mediated mechanism (B -2.05, OR 0.12, 95% CI 0.06-0.26; P < .001); and (2) formula choice, such that those receiving either EHCF (B 1.48, OR 4.41, 95% CI 1.44-13.48; P = .009) or EHCF + LGG (B 3.35, OR 28.62, 95% CI 8.72-93.93; P < .001). EHCF accelerates tolerance acquisition in children with CMA if compared with other dietetic choices. This effect is augmented by LGG. Copyright © 2013 Mosby, Inc. All rights reserved.

Formula Selection for Management of Children with Cow's Milk Allergy Influences the Rate of Acquisition of Tolerance: A Prospective Multicenter Study / Roberto Berni, Canani; Rita, Nocerino; Terrin, Gianluca; Frediani, Tullio; Lucarelli, Sandra; Linda, Cosenza; Annalisa, Passariello; Ludovica, Leone; Viviana, Granata; Margherita Di, Costanzo; Vincenza, Pezzella; Riccardo, Troncone. - In: THE JOURNAL OF PEDIATRICS. - ISSN 0022-3476. - 163:3(2013), pp. 771-777.e1. [10.1016/j.jpeds.2013.03.008]

Formula Selection for Management of Children with Cow's Milk Allergy Influences the Rate of Acquisition of Tolerance: A Prospective Multicenter Study

TERRIN, GIANLUCA;FREDIANI, Tullio;LUCARELLI, Sandra;
2013

Abstract

To prospectively evaluate the effect of different dietary management strategies on the rate of acquisition of tolerance in children with cow's milk allergy (CMA). Otherwise healthy children (aged 1-12 months) diagnosed with CMA were prospectively evaluated. The study population was divided into 5 groups based upon the formula used for management: (1) extensively hydrolyzed casein formula ([EHCF], n = 55); (2) EHCF + Lactobacillus rhamnosus GG [LGG], n = 71); (3) hydrolyzed rice formula (RHF, n = 46); (4) soy formula (n = 55); and (5) amino acid based formula (n = 33). A food challenge was performed after 12 months to assess acquisition of tolerance. Two hundred sixty children were evaluated (167 male, 64.2%; age 5.92 months, 95% CI 5.48-6.37; body weight 6.66 kg, 95% CI 6.41-6.91; IgE-mediated CMA 111, 42.7%). The rate of children acquiring oral tolerance after 12 months was significantly higher (P < .05) in the groups receiving EHCF (43.6%) or EHCF + LGG (78.9%) compared with the other groups: RHF (32.6%), soy formula (23.6%), and amino acid based formula (18.2%). Binary regression analysis coefficient (B) revealed that the rate of patients acquiring tolerance at the end of the study was influenced by 2 factors: (1) IgE-mediated mechanism (B -2.05, OR 0.12, 95% CI 0.06-0.26; P < .001); and (2) formula choice, such that those receiving either EHCF (B 1.48, OR 4.41, 95% CI 1.44-13.48; P = .009) or EHCF + LGG (B 3.35, OR 28.62, 95% CI 8.72-93.93; P < .001). EHCF accelerates tolerance acquisition in children with CMA if compared with other dietetic choices. This effect is augmented by LGG. Copyright © 2013 Mosby, Inc. All rights reserved.
2013
aaf; b; apt; double-blind placebo-controlled food challenge; binary regression analysis coefficient; ehcf; hydrolyzed rice formula; skin prick testing; cmp; sf; dbpcfc; spt; atopy patch testing; cow milk; soy formula; cm; rhf; amino acid based formula; extensively hydrolyzed casein formula; lgg; lactobacillus rhamnosus gg; cma; cow milk proteins; cow's milk allergy
01 Pubblicazione su rivista::01a Articolo in rivista
Formula Selection for Management of Children with Cow's Milk Allergy Influences the Rate of Acquisition of Tolerance: A Prospective Multicenter Study / Roberto Berni, Canani; Rita, Nocerino; Terrin, Gianluca; Frediani, Tullio; Lucarelli, Sandra; Linda, Cosenza; Annalisa, Passariello; Ludovica, Leone; Viviana, Granata; Margherita Di, Costanzo; Vincenza, Pezzella; Riccardo, Troncone. - In: THE JOURNAL OF PEDIATRICS. - ISSN 0022-3476. - 163:3(2013), pp. 771-777.e1. [10.1016/j.jpeds.2013.03.008]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/525175
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