Half of the children who received oral immunotherapy for a cows' milk allergy consumed milk freely after 2.5 years.

Abstract

Strict milk protein avoidance has been the standard therapy of cows' milk allergy (CMA) in children, but oral immunotherapy (OIT) seems to provide an alternative treatment. The aim of this study was to evaluate the impact of OIT on milk consumption during the first 2.5 years after a start of OIT. This open-label, noncontrolled, real-life OIT study was conducted in 74 children with CMA, who were aged 5-15. It included a 6-month induction phase and a 2-year maintenance phase. Data on the complete 2.5-year trial were available for 57 children. Most of the children (82%) completed the 6-month induction phase and were able to consume at least 200 mL of milk or 6400 mg of milk protein a day. After the 2-year maintenance phase, half were consuming milk daily. Risk factors for OIT failure during the induction phase were asthma and high milk-specific immunoglobulin E, but a history of anaphylaxis before OIT was not. Allergies to eggs or wheat decreased the risk of immediate OIT failure. This study confirmed the efficacy of milk OIT in real life, including the whole spectrum of persistent CMA at school age, and revealed certain risk factors associated with OIT failure.