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The Impact of Formula Choice for the Management of Pediatric Cow's Milk Allergy on the Occurrence of Other Allergic Manifestations: The Atopic March Cohort Study.
- Source :
-
The Journal of pediatrics [J Pediatr] 2021 May; Vol. 232, pp. 183-191.e3. Date of Electronic Publication: 2021 Jan 29. - Publication Year :
- 2021
-
Abstract
- Objectives: To compare the impact of different formulas on the occurrence of other atopic manifestations and the time of immune tolerance acquisition.<br />Study Design: In a 36-month prospective cohort study, the occurrence of other atopic manifestations (eczema, urticaria, asthma, and rhinoconjunctivitis) and the time of immune tolerance acquisition were comparatively evaluated in immunoglobulin E-mediated children with cow's milk allergy (CMA) treated with extensively hydrolyzed casein formula containing the probiotic L. rhamnosus GG (EHCF + LGG), rice hydrolyzed formula, soy formula, extensively hydrolyzed whey formula (EHWF), or amino acid-based formula.<br />Results: In total, 365 subjects were enrolled into the study, 73 per formula cohort. The incidence of atopic manifestations was 0.22 (Bonferroni-corrected 95% CI 0.09-0.34) in the EHCF + LGG cohort; 0.52 (0.37-0.67) in the rice hydrolyzed formula cohort; 0.58 (0.43-0.72) in the soy formula cohort; 0.51 (0.36-0.66) in the EHWF cohort; and 0.77 (0.64-0.89) in the amino acid-based formula cohort. The incidence of atopic manifestations in the rice hydrolyzed formula, soy formula, EHWF, and amino acid-based formula cohorts vs the EHCF + LGG cohort was always greater than the prespecified absolute difference of 0.25 at an alpha-level of 0.0125, with corresponding risk ratios of 2.37 (1.46-3.86, P < .001) for rice hydrolyzed formula vs EHCF + LGG; 2.62 (1.63-4.22, P < .001) for soy formula vs EHCF + LGG; 2.31 (1.42-3.77, P < .001) for EHWF vs EHCF + LGG; and 3.50 (2.23-5.49, P < .001) for amino acid-based formula vs EHCF + LGG. The 36-month immune tolerance acquisition rate was greater in the EHCF + LGG cohort.<br />Conclusions: The use of EHCF + LGG for CMA treatment is associated with lower incidence of atopic manifestations and greater rate of immune tolerance acquisition.<br /> (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Amino Acids
Asthma epidemiology
Asthma immunology
Caseins
Child, Preschool
Conjunctivitis, Allergic epidemiology
Conjunctivitis, Allergic immunology
Dermatitis, Atopic epidemiology
Dermatitis, Atopic immunology
Female
Follow-Up Studies
Humans
Incidence
Infant
Lacticaseibacillus rhamnosus
Male
Milk Hypersensitivity complications
Milk Hypersensitivity immunology
Oryza
Probiotics therapeutic use
Prospective Studies
Rhinitis, Allergic epidemiology
Rhinitis, Allergic immunology
Glycine max
Treatment Outcome
Whey
Asthma prevention & control
Conjunctivitis, Allergic prevention & control
Dermatitis, Atopic prevention & control
Immune Tolerance
Infant Formula adverse effects
Infant Formula chemistry
Infant Formula microbiology
Milk Hypersensitivity diet therapy
Rhinitis, Allergic prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6833
- Volume :
- 232
- Database :
- MEDLINE
- Journal :
- The Journal of pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 33524387
- Full Text :
- https://doi.org/10.1016/j.jpeds.2021.01.059