Best Allergy Articles 2021 -Cow’s Milk Allergy (Part 2)

In Pediatrics, supplement 3 summarizes 76 articles: Synopsis Book: Best Articles Relevant to Pediatric Allergy, Asthma and Immunology

Some of the studies that are most relevant to pediatric GI doctors I am reviewing for this blog over the next few days.

R Nocerino et al. J Pediatr 2021; 232: 183-191. Open Access: The Impact of Formula Choice for the Management of Pediatric Cow’s Milk Allergy on the Occurrence of Other Allergic Manifestations: The Atopic March Cohort Study

Methods: In a 36-month prospective cohort study (n=365), the occurrence of other atopic manifestations (eczema, urticaria, asthma, and rhinoconjunctivitis) and the time of immune tolerance acquisition were comparatively evaluated in children with oral food challenge-confirmed IgE-mediated cow’s milk allergy (CWA). 5 groups were treated with extensively hydrolyzed casein formula containing the probiotic L. rhamnosus GG (EHCF + LGG), rice hydrolyzed formula, soy formula, extensively hydrolyzed whey formula (EHWF), or amino acid–based formula.

Key finding:

  • The use of EHCF + LGG for CMA treatment was associated with lower incidence of atopic manifestations and greater rate of immune tolerance acquisition.

The risk ratios:  

  • 2.37 (1.46-3.86, P < .001) for rice hydrolyzed formula vs EHCF + LGG
  • 2.62 (1.63-4.22, P < .001) for soy formula vs EHCF + LGG
  • 2.31 (1.42-3.77, P < .001) for EHWF vs EHCF + LGG
  • 3.50 (2.23-5.49, P < .001) for amino acid–based formula vs EHCF + LGG

Limitations: non-blinded study, exclusion of patients with anaphylaxis-CMA