Abstract
Symptoms related cow’s milk proteins allergy (CMPA) usually improve between two to four weeks following an elimination diet, firstly with extensively hydrolyzed formulas (eHF). The aim of the EVA study was to observe the evolution of CMPA-related symptoms in real life after initiation of a whey-based extensively hydrolyzed formula (w-eHF, Althéra®, Nestlé Health Science, Switzerland). This cross-sectional prospective non-interventional study was carried out alongside paediatricians in private practice in France between June 2019 and June 2020. Infants aged 0–3 years presenting with confirmed diagnosis or clinical symptoms suggesting CMPA were enrolled. Data were collected at enrolment (baseline visit) and three to five weeks later (follow-up visit). Symptoms were assessed using the Cow’s Milk-related Symptom Score (CoMiSS®). The per protocol population included 135 infants. The average number of symptoms per infant significantly decreased under the study formula (from 2.81 to 1.36, p < 0.001) and the proportions of infants with any CMPA related symptoms decreased. Daily crying and regurgitation showed the largest decline, respectively −44.4% and −31.85% (p < 0.001). These results describe the early management of symptoms suspected to be related to CMPA in routine practice that was rarely described in the literature. The number and severity of symptoms decreased most of the cases after commencing the study formula.
Highlights
The CoMiSS® questionnaire is an awareness tool used in primary clinical practice [15,16] to capture and score the following symptoms: duration of daily crying, number and duration of episodes of regurgitation, stool type according to Bristol scale
This study provided recent evidence on the real-world management of cow’s milk proteins allergy (CMPA) in primary care in France as well as on the real-life progression of CMPA symptoms three to five weeks after a first prescription of the study formula
These results describe the early management of symptoms suspected to be related to CMPA in routine practice that was rarely described in the literature
Summary
The aim of the EVA study was to observe the evolution of CMPA-related symptoms in real life after initiation of a whey-based extensively hydrolyzed formula (w-eHF, Althéra® , Nestlé Health Science, Switzerland). This cross-sectional prospective non-interventional study was carried out alongside paediatricians in private practice in France between June 2019 and June 2020. Cow’s milk is the main food allergen in young children under three years of age [1]. Non-IgE-mediated CMPA may be delayed by up to one week after ingestion with frequent symptoms of skin reactions and digestive manifestations occurring in 50 to 60% of patients [1,3,5]
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