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This article is part of the supplement: Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2012

Open Access Meeting abstract

Oral immunotherapy for milk allergy: a systematic review

Joanne P Yeung1*, Lorie A Kloda2, Jason R McDevitt3, Moshe Ben-Shoshan1 and Reza Alizadehfar1

Author Affiliations

1 Pediatric Allergy and Immunology, McGill University, Montreal, Quebec, Canada, H3H 1P3

2 Libraries, McGill University, Montreal, Quebec, Canada, H3G 1Y6

3 Faculty of Medicine, McGill University, Montreal, Quebec, Canada, H3A 1W9

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Allergy, Asthma & Clinical Immunology 2012, 8(Suppl 1):A14  doi:10.1186/1710-1492-8-S1-A14

The electronic version of this article is the complete one and can be found online at: http://www.aacijournal.com/content/8/S1/A14


Published:2 November 2012

© 2012 Yeung et al; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background

Milk oral immunotherapy (MOIT) may be an alternative to avoidance in treatment of patients with IgE-mediated cow milk allergy (IMCMA). We aim to determine the effect of MIOT through a systematic review.

Methods

Randomized controlled trials on MOIT were identified from 13 databases, conference proceedings, theses and unpublished trials, as part of a review with the Cochrane Collaboration. A total 1945 records were identified and screened. Children and adults with IMCMA were included. Studies were selected and methodological quality assessed independently by two reviewers.

Results

138 records were reviewed and 13 were included, representing 4 trials. A total of 170 patients were studied (88 MOIT, 82 control). Two studies used blinding and 2 used an avoidance diet control. Fifty-two (59%) patients of the MOIT group were able to tolerate a full serving of milk (about 200 mL) compared to 7 (9%) of the control group (RR 6.05, 95% CI 3.2, 11.44). In addition, 26 (30%) in the MOIT group could ingest a partial serving of milk (10-184 mL) while none could in the control group (RR 11.55, 95% CI 2.85, 46.87). None of the studies assessed the patients following a period off immunotherapy. Adverse reactions were common (79 of 88 had at least one symptom), although most were local and mild. For every 7 patients receiving MOIT, 1 required intramuscular epinephrine. One patient required it on 2 occasions.

Conclusion

MOIT can lead to desensitization in the majority of individuals with IMCMA although the development of long-term tolerance has not been established.