New treatment may desensitise children with milk allergy

A small clinical study by immunologists and allergists at Children’s Hospital Boston and Stanford University School of Medicine has shown that children with milk allergy can be successfully desensitised by a combination of increasing their exposure to milk whilst administering a drug called omalizumab. The treatment allows children to build up resistance more quickly to milk with fewer allergic reactions.

The researchers showed that most of the subjects who had been milk allergic at the beginning of the study were able to ingest the equivalent of eight ounces of milk or more per day by the end of the study. Previous studies showed that desensitisation can increase the amount of milk tolerated by milk allergic subjects, but Dr Lynda Schneider and Dr Dale Umetsu PhD at Children’s Hospital, and Dr Kari Nadeau at Stanford University wanted to speed up desensitisation and decrease the number of allergic reactions experienced during the trial. The drug used, omalizumab binds up the IgE antibodies that drive allergic responses, and this is the first trial to use the drug in combination with desensitisation.

The children in the trial were first treated with omalizumab, and then introduced increasing amounts of milk over a seven to 10 week period, which is relatively rapid desensitisation period. For the first part of the trial the drug was given to decrease the severity and occurrence of allergic reactions – during desensitisation (oral immunotherapy) up to 20% of people taking part drop out because of intolerable allergic reactions experienced.

At the end of the desensitisation period the patients were still given daily doses of milk but without the drug omalizumab. Nine of the 11 children were given an oral challenge of milk, and the next day these nine children began to ingest 8-12 ounces of milk per day to maintain their tolerance – with no adverse effects.

Milk allergy was chosen for this trial because milk is very difficult to avoid as many foods have some milk protein in them. Successful treatment of milk allergy would allow children to increase all types of milk products in their diets.

Schneider and Umetsu are beginning a trial, based on the results of this study, on peanut allergy.

Source: Stanford School of Medicine

First published in March 2011

 

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