Efficacy of Starting Very-Low-Dose Cow's Milk Intake in Children Aged 1-12 Years With Severe Cow's Milk Allergy: A Retrospective Study.
- 1Department of Pediatrics, Showa Medical University School of Medicine, Tokyo, Japan. [email protected].
- 2Department of Pediatrics, Showa Medical University School of Medicine, Tokyo, Japan.
Abstract
Purpose
To avoid the complete elimination of cow's milk (CM) from the diet, we introduced a very-low-dose (VLD) oral food challenge (OFC) as part of an OFC-based stepwise ingestion protocol in patients with severe CM allergy in 2019, when the OFC protocol at our center was revised. This study investigated the efficacy of initiating CM intake through an OFC-based stepwise ingestion protocol starting from a VLD in achieving a negative full-dose OFC.Methods
Patients with a history of overt allergic reactions to low-dose (LD; 3 mL CM: 100 mg CM protein) CM or lesser within 6 months and those with complete CM elimination were included. We retrospectively compared the rate of passing a full-dose OFC (200 mL CM: 6,600 mg CM protein) between patients who underwent an LD OFC before 2019 (LD group) and those who underwent a VLD OFC (0.3 mL CM: 10 mg CM protein) after 2019 (VLD group). The period for passing the full-dose OFC was evaluated using Kaplan-Meier survival analyses.Results
We allocated 270 and 267 patients into the LD and VLD groups, respectively. The median age at initiation of the OFC-based stepwise ingestion protocol was 3.6 (2.3-5.4) and 3.4 (2.0-5.1) years in the LD and VLD groups, respectively. The LD and VLD groups had CM-specific immunoglobulin E levels of 21.9 (10.9-44.0) kUA/L and 20.5 (9.0-47.2) kUA/L, respectively. The baseline clinical characteristics of the two groups showed no significant differences in background. Over 4 years, the LD and VLD groups passed the full-dose OFC at rates of 45% and 60%, respectively, with a significant difference (log-rank test, P = 0.023).Conclusions
Initiating CM intake through an OFC-based stepwise ingestion protocol starting from a VLD may contribute to achieving a negative full-dose OFC in patients with severe CM allergies.
Related
- Food allergy and attention-deficit/hyperactivity disorder in children: evidence and implications for pediatric allergy practice
- Efficacy and Safety of Abatacept Versus Placebo During Peanut Oral Immunotherapy for Adults With Severe Peanut Allergy
- Hydrolyzed Rice Formula for the Management of Cow’s Milk Allergy in Infants and Young Children: A Systematic Review of Randomized Controlled Trials
- Research Priorities for Children With Food Allergy: A UK James Lind Alliance Priority Setting Partnership
- Effect of the number of sensitizing allergens on the efficacy of subcutaneous immunotherapy and quality of life in children with asthma
BibTeX
@article{yamashita2026efficacy,
title = {{Efficacy of Starting Very-Low-Dose Cow's Milk Intake in Children Aged 1-12 Years With Severe Cow's Milk Allergy: A Retrospective Study.}},
author = {Kosei Yamashita and Takanori Imai and Sawa Seki and Toshiyuki Takagi and Megumi Okawa and Aiko Honda and Chihiro Kunigami and Yuki Okada and Mayu Maeda and Taro Kamiya},
journal = {Allergy, asthma \& immunology research},
year = {2026},
month = sep,
doi = {10.4168/aair.2026.18.5.738},
url = {https://europepmc.org/article/MED/42845228},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Efficacy of Starting Very-Low-Dose Cow's Milk Intake in Children Aged 1-12 Years With Severe Cow's Milk Allergy: A Retrospective Study.
AU - Kosei Yamashita
AU - Takanori Imai
AU - Sawa Seki
AU - Toshiyuki Takagi
AU - Megumi Okawa
AU - Aiko Honda
AU - Chihiro Kunigami
AU - Yuki Okada
AU - Mayu Maeda
AU - Taro Kamiya
PY - 2026
DA - 2026/09/01
JO - Allergy, asthma & immunology research
DO - 10.4168/aair.2026.18.5.738
UR - https://europepmc.org/article/MED/42845228
AB - Purpose To avoid the complete elimination of cow's milk (CM) from the diet, we introduced a very-low-dose (VLD) oral food challenge (OFC) as part of an OFC-based stepwise ingestion protocol in patients with severe CM allergy in 2019, when the OFC protocol at our center was revised. This study investigated the efficacy of initiating CM intake through an OFC-based stepwise ingestion protocol starting from a VLD in achieving a negative full-dose OFC.Methods Patients with a history of overt allergic reactions to low-dose (LD; 3 mL CM: 100 mg CM protein) CM or lesser within 6 months and those with complete CM elimination were included. We retrospectively compared the rate of passing a full-dose OFC (200 mL CM: 6,600 mg CM protein) between patients who underwent an LD OFC before 2019 (LD group) and those who underwent a VLD OFC (0.3 mL CM: 10 mg CM protein) after 2019 (VLD group). The period for passing the full-dose OFC was evaluated using Kaplan-Meier survival analyses.Results We allocated 270 and 267 patients into the LD and VLD groups, respectively. The median age at initiation of the OFC-based stepwise ingestion protocol was 3.6 (2.3-5.4) and 3.4 (2.0-5.1) years in the LD and VLD groups, respectively. The LD and VLD groups had CM-specific immunoglobulin E levels of 21.9 (10.9-44.0) kUA/L and 20.5 (9.0-47.2) kUA/L, respectively. The baseline clinical characteristics of the two groups showed no significant differences in background. Over 4 years, the LD and VLD groups passed the full-dose OFC at rates of 45% and 60%, respectively, with a significant difference (log-rank test, P = 0.023).Conclusions Initiating CM intake through an OFC-based stepwise ingestion protocol starting from a VLD may contribute to achieving a negative full-dose OFC in patients with severe CM allergies.
SN - 2092-7355
SN - 2092-7363
ER -