RESUMO
BACKGROUND: Food allergy (FA) negatively affects quality of life in caregivers of food-allergic children, imposing a psychosocial and economic burden. Oral immunotherapy (OIT) is a promising investigational therapy for FA. However, OIT can be a source of anxiety as it carries risk for allergic reactions. The effect of OIT with multiple food allergens (mOIT) on FA-specific health-related quality of life (HRQL) has never been studied in participants with multiple, severe food allergies. This study is the first to investigate the effects of mOIT on FA-related HRQL in caregivers of pediatric subjects. METHODS: Caregiver HRQL was assessed using a validated Food Allergy Quality of Life - Parental Burden (FAQL-PB) Questionnaire (J Allergy Clin Immunol 114(5):1159-1163, 2004). Parents of participants in two single-center Phase I clinical trials receiving mOIT (n = 29) or rush mOIT with anti-IgE (omalizumab) pre-treatment (n = 11) completed the FAQL-PB prior to study intervention and at 2 follow-up time-points (6 months and 18 months). Parents of subjects not receiving OIT (control group, n = 10) completed the FAQL-PB for the same time-points. RESULTS: HRQL improved with clinical (change < -0.5) and statistical (p < 0.05) significance in the mOIT group (baseline mean 3.9, 95% CI 3.4-4.4; 6-month follow-up mean 2.5, 95% CI 2.0-3.0; 18-month follow-up mean 1.8, 95% CI 1.4-2.1) and rush mOIT group (baseline mean 3.9, 95% CI 3.1-4.7; 6-month follow-up mean 1.7, 95% CI 0.9-2.6; 18-month follow-up mean 1.3, 95% CI 0.3-2.4). HRQL scores did not significantly change in the control group (n = 10). CONCLUSION: Multi-allergen OIT with or without omalizumab leads to improvement in caregiver HRQL, suggesting that mOIT can help relieve the psychosocial and economic burden FA imposes on caregivers of food-allergic children.
RESUMO
CME EDUCATIONAL OBJECTIVES 1. Recognize and appreciate the impact of food allergies on psychosocial health. 2. List the factors that have been shown to negatively affect health-related quality of life. 3. Understand how physicians can directly help to improve a child's quality of life while living with food allergies. Food allergy is a serious problem affecting a growing number of children worldwide. There is a large body of evidence supporting the detrimental effects that food allergy can have on a child's quality of life. With validated tools, we can identify these children and focus on how to protect, guide, and help them to live a safe life. Recent research articulates how food allergies impact health-related quality of life (HRQL). There are studies reported from the child's perspective, as well as studies reported from the parent's perspective. With the development of validated disease and age-specific questionnaires, researchers can reliably gather data on the psychological aspect of children with food allergies. The purpose of this article is to provide a review of the literature examining the psycho-social impact of food allergies on children. This article was designed to outline suggestions to help physicians care for the whole child - both mind and body.