Possibility of Using Epicutaneous Immunotherapy to Induce Tolerance in Children and adolescent Affected with Cow’s Milk Allergy
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on June 7th, 2024
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Despite the major reduction in the quality of life of those who are affected by cow’s milk allergy, there are currently no approved biological interventions besides avoidance. Epicutaneous exposure with the allergen had been tested as a management tool for peanut allergy. An article, recently published in the Journal of the American Medical Association, had investigated the usage of epicutaneous immunotherapy containing milk allergen to manage cow’s milk allergy in children and adolescents.
The clinical trial included 198 participants between the age of 2 and 17 years old who had previously been diagnosed with cow milk allergy via a skin-prick test and a IgE level greater than 10 kUA per liter. The children were randomly assigned to be treated with placebo or 3 dose levels of cow milk allergen (150 μg, 300 μg, or 500 μg) delivered epicutaneous daily. After 12 months of treatment, oral challenge with cow milk showed that epicutaneous immunotherapy with 300 ug of cow milk was the most effective at induce tolerance. This observation is only true for children between the ages of 2-11 but becomes insignificant when the age range is widened to 12-17 years old. Additionally, there was limited benefit observed in those treated with 150 μg and 500 μg. Due to the small number of participants in each treatment group, the researchers could not draw a definitive conclusion on the efficacy of the treatment; which required a larger-scale phase 3 study to elucidate.
The clinical trial included 198 participants between the age of 2 and 17 years old who had previously been diagnosed with cow milk allergy via a skin-prick test and a IgE level greater than 10 kUA per liter. The children were randomly assigned to be treated with placebo or 3 dose levels of cow milk allergen (150 μg, 300 μg, or 500 μg) delivered epicutaneous daily. After 12 months of treatment, oral challenge with cow milk showed that epicutaneous immunotherapy with 300 ug of cow milk was the most effective at induce tolerance. This observation is only true for children between the ages of 2-11 but becomes insignificant when the age range is widened to 12-17 years old. Additionally, there was limited benefit observed in those treated with 150 μg and 500 μg. Due to the small number of participants in each treatment group, the researchers could not draw a definitive conclusion on the efficacy of the treatment; which required a larger-scale phase 3 study to elucidate.