Oral desensitization as a useful treatment in 2‐year‐old children with cow's milk allergy

Summary Background Limited published evidence shows oral desensitization to be a potential intervention option for cow's milk protein (CMPs) allergy. Objective The aim of this study was to evaluate the safety and efficacy of oral desensitization in 2‐year‐old children with cow's milk allergy, as a treatment alternative to elimination diet. Methods A total of 60 children aged 24–36 months with IgE‐mediated allergy to CMPs were included in this multi‐center study and were randomized into two groups. Thirty children (group A: treatment group) began oral desensitization immediately, whereas the remaining 30 (group B: control group) were kept on a milk‐free diet and followed‐up for 1 year. Results After 1‐year follow‐up period, 90% of the children in group A had become completely tolerant vs. 23% of the children in group B. In group A, cow's milk skin reactivity and serum‐specific IgE to milk and casein decreased significantly from the initial assessment, whereas group B showed no significant change after 1 year of follow‐up. Twenty‐four patients (80%) developed some reaction during the treatment period: 14 children developed moderate reaction (47%) and 10 mild reaction (33%). The most common manifestations were urticaria‐angioedema, followed by cough. Conclusions and Clinical Relevance In this study, oral desensitization was found to be effective in a significant percentage of 2‐year‐old children with cow's milk allergy. Oral desensitization appears to be efficacious as an alternative to elimination diet in the treatment of 2‐year‐old children with cow's milk allergy. The side‐effect profile appears acceptable but requires further study. Cite this as: A. Martorell, B. De la Hoz, M. D. Ibáñez, J. Bone, M. S. Terrados, A. Michavila, A. M. Plaza, E. Alonso, J. Garde, S. Nevot, L. Echeverria, C. Santana, J. C. Cerdá, C. Escudero, I. Guallar, M. Piquer, L. Zapatero, L. Ferré, T. Bracamonte, A. Muriel, M. I. Martínez and R. Félix, Clinical & Experimental Allergy, 2011 (41) 1297–1304.