Do Longer Intervals between Challenges Reduce the Risk of Adverse Reactions in Oral Wheat Challenges?
Open Access
- 1 December 2015
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 10 (12), e0143717
- https://doi.org/10.1371/journal.pone.0143717
Abstract
The use of oral food challenges (OFCs) in clinics is limited because they are complicated and associated with anaphylactic symptoms. To increase their use, it is necessary to develop novel, effective, and safe methods. However, the effectiveness of different OFCs has not been compared. To investigate the effect of ingestion methods on wheat allergy symptoms and treatment during OFCs. Without changing the total challenge dose, we changed the administration method from a 5-installment dose titration every 15 min (15-min interval method) to 3 installments every 30 min (30-min interval method). We retrospectively reviewed and compared the results of 65 positive 15-min interval wheat challenge tests conducted between July 2005 and February 2008 and 87 positive 30-min interval tests conducted between March 2008 and December 2009. A history of immediate symptoms was more common for the 30-min interval method; however, no difference between methods was observed in other background parameters. Switching from the 15-min to the 30-min interval method did not increase symptoms or require treatment. The rate of cardiovascular symptoms (p = 0.032), and adrenaline use (p = 0.017) was significantly lower with the 30-min interval method. The results did not change after adjusting for the effects of immediate symptom history in multivariate analysis. This study suggests that the 30-min interval method reduces the risk of adverse events, compared to the 15-min interval method.Keywords
This publication has 18 references indexed in Scilit:
- Standardizing double-blind, placebo-controlled oral food challenges: American Academy of Allergy, Asthma & Immunology–European Academy of Allergy and Clinical Immunology PRACTALL consensus reportJournal of Allergy and Clinical Immunology, 2012
- 2012 UpdateCurrent Opinion in Allergy and Clinical Immunology, 2012
- Outcome of oral food challenges in children in relation to symptom‐eliciting allergen dose and allergen‐specific IgEAllergy, 2012
- NIAID-Sponsored 2010 Guidelines for Managing Food Allergy: Applications in the Pediatric PopulationPEDIATRICS, 2011
- World Allergy Organization anaphylaxis guidelines: SummaryJournal of Allergy and Clinical Immunology, 2011
- Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert PanelJournal of Allergy and Clinical Immunology, 2010
- Work Group report: Oral food challenge testingJournal of Allergy and Clinical Immunology, 2009
- The natural history of wheat allergyAnnals of Allergy, Asthma & Immunology, 2009
- Management of Food Allergy in Japan “Food Allergy Management Guideline 2008 (Revision from 2005)” and “Guidelines for the Treatment of Allergic Diseases in Schools”Allergology International, 2009
- Standardization of food challenges in patients with immediate reactions to foods – position paper from the European Academy of Allergology and Clinical ImmunologyAllergy, 2004