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J Allergy Clin Immunol Pract. 2019 Feb;7(2):429-436.e2. doi: 10.1016/j.jaip.2018.06.016. Epub 2018 Jul 7.

Quality of Life of Food-Allergic Patients Before, During, and After Oral Immunotherapy.

Author information

1
Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel. Electronic address: naamaepstein@gmail.com.
2
Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel.
3
Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel; Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Abstract

BACKGROUND:

Oral immunotherapy (OIT) for food allergy is demanding but data on patients' quality of life (QOL) throughout the process are limited.

OBJECTIVE:

To characterize changes in QOL of food-allergic patients during and after OIT.

METHODS:

In a prospective cohort study, the Food Allergy Quality of Life Questionnaire-Parental Form (FAQLQ-PF) was administered to parents of 191 consecutive children aged 4 to 12 years undergoing OIT for food allergy. Questionnaires were administered at OIT initiation, mid up-dosing, upon reaching maintenance, and after 6 months of follow-up. Age- and sex-matched food-allergic children (n = 48) not undergoing OIT served as controls.

RESULTS:

FAQLQ-PF scores had significantly improved (decreased) from OIT initiation to reaching full maintenance (emotional impact [EI], 3.66-3.32, P = .001; food anxiety [FA], 3.90-3.32, P < .001; social and dietary limitation [SDL], 3.50-2.94, P < .001; and total score, 3.69-3.19, P < .001) and partial maintenance, whereas no change was noted in control patients. Worse baseline QOL, single food allergy, and a younger age predicted greater QOL improvement. Of the 85 (88.5%) patients who completed the FAQLQ-PF at mid up-dosing and for whom QOL deteriorated, a significant improvement was noted upon reaching maintenance. Additional significant improvement in QOL was observed in the 95 (88.8%) patients who completed the FAQLQ-PF 6 months after reaching maintenance (EI, 3.414-2.993, P = 0.049; FA, 3.37-2.593, P = .001; SDL, 2.989-2.264, P = .001; and total score, 3.266-2.614, P = .001).

CONCLUSION:

The QOL of food-allergic children improves significantly upon reaching OIT maintenance, with additional improvement 6 months later. The detrimental effect of OIT on some patients' QOL during up-dosing is reversed upon reaching maintenance.

KEYWORDS:

Desensitization; Follow-up; Maintenance; Oral immunotherapy; Quality of life; Up-dosing phase

PMID:
30129441
DOI:
10.1016/j.jaip.2018.06.016

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