Background: Cow’s milk allergy(CMA) is the most common allergy in
infants that decreases the quality of life of patients and their
families. Standard treatment for CMA is the strict avoidance of milk,
new treatment strategies such as oral immunotherapy (OIT) have been
sought for patients with CMA . We aimed to assess the clinical efficacy
and safety of OIT in the treatment of children with IgE-mediated cow’s
milk allergy (IMCMA). Methods: We searched all randomized controlled
trials (RCTs) in which OIT is used to treat children with IMCMA from 5
international electronic databases. We estimated a pooled relative ratio
(RR) for each outcome using a Mantel-Haenzel fixed-effect model if
statistical heterogeneity was low. Results: Eleven studies were chosen
for meta-analysis, including a total of 469 children (242 OIT, 227
control). 176 patients (72.7%) in the OIT were desensitized compared to
49 patients in the control group (RR 7.35, 95%CI 2.82-19.13,
p<0.0001). The desensitization effect of OIT was particularly
significant in children over 3 years old (RR 18.05, 95%CI 6.48-50.26,
p<0.00001). Although adverse effects were common, they usually
involved mild reactions, but epinephrine use was more common in the OIT
group (RR 7.69, 95%CI 2.16-27.33, p<0.002). Conclusion: OIT
can lead to desensitization in the majority of individuals with IMCMA,
especially in patients over 3-years old. A major problem of OIT is the
frequency of adverse events, although most are mild. OIT may be an
alternative treatment in the future.
Slow oral immunotherapy for cow's milk allergy with anaphylaxis to extensively hydrolyzed formula
