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Two year effects of food allergen immunotherapy on quality of life in caregivers of children with food allergies.

Arasi S, Otani IM, Klingbeil E, Bégin P, Kearney C, Dominguez TL, Block WM, O'Riordan G, Nadeau KC - Allergy Asthma Clin Immunol (2014)

Bottom Line: Caregiver HRQL improved significantly (change < - 0.5, p <0.0001) at each follow-up time point compared to baseline.Caregivers of participants with pre-existing asthma or dose-related respiratory allergic reactions had less improvement in HRQL than those who did not (p <0.01).Certain characteristics were associated with greater improvements in caregiver HRQL.

View Article: PubMed Central - PubMed

Affiliation: Stanford Alliance for Food Allergy Research, Palo Alto, CA USA ; Department of Pediatrics, Division of Immunology and Allergy, Stanford University, 269 Campus Drive, CCSR Building Suite 3215, Stanford, CA 94305 USA.

ABSTRACT

Background: Food allergy (FA) can have serious psychosocial and economic repercussions on food-allergic children and their caregivers and be associated with negative effects on their quality of life. Food allergen immunotherapy (IT) is a promising experimental therapy but can be linked to anxiety. This study investigated the effects of IT on FA-specific health-related quality of life (HRQL) over a 24 month-follow-up in caregivers of children with single and multiple food allergies. We hypothesized that characteristics such as age, asthma at baseline and respiratory allergic reactions during therapy were key characteristics that influenced HRQL scores.

Methods: A validated Food Allergy Quality of Life - Parental Burden Questionnaire (FAQL-PB) was used to assess HRQL. It was randomly distributed to and filled out by caregivers of 57 food-allergic children enrolled in clinical trials of IT. The same parent answered the FABQL-PB questionnaire at baseline and for 6-month, 12- month, 18- month, and 24-month time points on IT.

Results: Caregiver HRQL improved significantly (change < - 0.5, p <0.0001) at each follow-up time point compared to baseline. The percentages of caregivers with improvement in HRQL progressively increased (92% at 24 month-follow-up time point compared to baseline). HRQL improved more in caregivers of participants older than 10 years or desensitized to more than 4 food allergens than those who were not (p <0.0001). Caregivers of participants with pre-existing asthma or dose-related respiratory allergic reactions had less improvement in HRQL than those who did not (p <0.01).

Conclusion: IT lead to improvement in caregiver HRQL. Certain characteristics were associated with greater improvements in caregiver HRQL.

No MeSH data available.


Related in: MedlinePlus

Changes in individual FAQL-PB question scores at 24-month follow-up time point from baseline for: a) baseline characteristics: (A) age, (B) asthma at baseline, (C) allergic rhinitis at baselineand (D) atopic dermatitis at baseline; b) adverse effects of therapy: (E) respiratory-related allergic reactions and (F) dosing- related abdominal pain and/or vomiting; c) number and type of food allergens: (G) 1-3 versus 4-5 foods; (H) milk; (I) cashew. Changes in individual FAQL-PB question scores are shown between caregivers of: (A) patients <10 years old and patients ≥10 years old; (B) patients with asthma and patients without asthma at baseline; (C) patients with allergic rhinitis and patients without allergic rhinitis at baseline; (D) patients with atopic dermatitis and without atopic dermatitis at baseline; (E) patients with at least one documented by a physician dosing- related respiratory adverse reaction (wheezing and/or cough) and patients without those; (F) patients with abdominal pain and/or vomiting and patients without abdominal pain and/or vomiting; (G) patients in treatment with 1-3 food allergens and patients in treatment with 4-5 food allergens; (H) patients in treatment with milk and patients not in treatment with milk; (I) patients in treatment with cashew and patients not in treatment with cashew. *p <0.05, **p <0.01, ***p <0.001, ****p <0.0001. Bars without asterisks represent non-significant changes.
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Fig2: Changes in individual FAQL-PB question scores at 24-month follow-up time point from baseline for: a) baseline characteristics: (A) age, (B) asthma at baseline, (C) allergic rhinitis at baselineand (D) atopic dermatitis at baseline; b) adverse effects of therapy: (E) respiratory-related allergic reactions and (F) dosing- related abdominal pain and/or vomiting; c) number and type of food allergens: (G) 1-3 versus 4-5 foods; (H) milk; (I) cashew. Changes in individual FAQL-PB question scores are shown between caregivers of: (A) patients <10 years old and patients ≥10 years old; (B) patients with asthma and patients without asthma at baseline; (C) patients with allergic rhinitis and patients without allergic rhinitis at baseline; (D) patients with atopic dermatitis and without atopic dermatitis at baseline; (E) patients with at least one documented by a physician dosing- related respiratory adverse reaction (wheezing and/or cough) and patients without those; (F) patients with abdominal pain and/or vomiting and patients without abdominal pain and/or vomiting; (G) patients in treatment with 1-3 food allergens and patients in treatment with 4-5 food allergens; (H) patients in treatment with milk and patients not in treatment with milk; (I) patients in treatment with cashew and patients not in treatment with cashew. *p <0.05, **p <0.01, ***p <0.001, ****p <0.0001. Bars without asterisks represent non-significant changes.

Mentions: We then examined the effect of baseline characteristics on the degree of HRQL improvement on IT at 24 months. Baseline demographic characteristics of the study participants are shown in Table 1. To determine if changes in the HRQL score were associated with age, we divided 35 subjects into two groups: age <10 years (n =22) and age ≥10 years (n =15). Caregivers of patients in the ≥10 years age group had significantly more improvement compared to those in the <10 years age group (p <0.0001) (Figure 2A). Within the FAQL-PB questionnaire of 17 questions, the questions related to choice of restaurant (p <0.0001), planning to participate in social activities with others involving food on one side (p <0.001), and about anxiety relating to food allergy (p <0.001) were the most significantly different for ages greater than or equal to 10 years (Figure 2A). There was no association between the gender of the participants and the change in HRQL score (Additional file 2: Figure S1A).


Two year effects of food allergen immunotherapy on quality of life in caregivers of children with food allergies.

Arasi S, Otani IM, Klingbeil E, Bégin P, Kearney C, Dominguez TL, Block WM, O'Riordan G, Nadeau KC - Allergy Asthma Clin Immunol (2014)

Changes in individual FAQL-PB question scores at 24-month follow-up time point from baseline for: a) baseline characteristics: (A) age, (B) asthma at baseline, (C) allergic rhinitis at baselineand (D) atopic dermatitis at baseline; b) adverse effects of therapy: (E) respiratory-related allergic reactions and (F) dosing- related abdominal pain and/or vomiting; c) number and type of food allergens: (G) 1-3 versus 4-5 foods; (H) milk; (I) cashew. Changes in individual FAQL-PB question scores are shown between caregivers of: (A) patients <10 years old and patients ≥10 years old; (B) patients with asthma and patients without asthma at baseline; (C) patients with allergic rhinitis and patients without allergic rhinitis at baseline; (D) patients with atopic dermatitis and without atopic dermatitis at baseline; (E) patients with at least one documented by a physician dosing- related respiratory adverse reaction (wheezing and/or cough) and patients without those; (F) patients with abdominal pain and/or vomiting and patients without abdominal pain and/or vomiting; (G) patients in treatment with 1-3 food allergens and patients in treatment with 4-5 food allergens; (H) patients in treatment with milk and patients not in treatment with milk; (I) patients in treatment with cashew and patients not in treatment with cashew. *p <0.05, **p <0.01, ***p <0.001, ****p <0.0001. Bars without asterisks represent non-significant changes.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4363059&req=5

Fig2: Changes in individual FAQL-PB question scores at 24-month follow-up time point from baseline for: a) baseline characteristics: (A) age, (B) asthma at baseline, (C) allergic rhinitis at baselineand (D) atopic dermatitis at baseline; b) adverse effects of therapy: (E) respiratory-related allergic reactions and (F) dosing- related abdominal pain and/or vomiting; c) number and type of food allergens: (G) 1-3 versus 4-5 foods; (H) milk; (I) cashew. Changes in individual FAQL-PB question scores are shown between caregivers of: (A) patients <10 years old and patients ≥10 years old; (B) patients with asthma and patients without asthma at baseline; (C) patients with allergic rhinitis and patients without allergic rhinitis at baseline; (D) patients with atopic dermatitis and without atopic dermatitis at baseline; (E) patients with at least one documented by a physician dosing- related respiratory adverse reaction (wheezing and/or cough) and patients without those; (F) patients with abdominal pain and/or vomiting and patients without abdominal pain and/or vomiting; (G) patients in treatment with 1-3 food allergens and patients in treatment with 4-5 food allergens; (H) patients in treatment with milk and patients not in treatment with milk; (I) patients in treatment with cashew and patients not in treatment with cashew. *p <0.05, **p <0.01, ***p <0.001, ****p <0.0001. Bars without asterisks represent non-significant changes.
Mentions: We then examined the effect of baseline characteristics on the degree of HRQL improvement on IT at 24 months. Baseline demographic characteristics of the study participants are shown in Table 1. To determine if changes in the HRQL score were associated with age, we divided 35 subjects into two groups: age <10 years (n =22) and age ≥10 years (n =15). Caregivers of patients in the ≥10 years age group had significantly more improvement compared to those in the <10 years age group (p <0.0001) (Figure 2A). Within the FAQL-PB questionnaire of 17 questions, the questions related to choice of restaurant (p <0.0001), planning to participate in social activities with others involving food on one side (p <0.001), and about anxiety relating to food allergy (p <0.001) were the most significantly different for ages greater than or equal to 10 years (Figure 2A). There was no association between the gender of the participants and the change in HRQL score (Additional file 2: Figure S1A).

Bottom Line: Caregiver HRQL improved significantly (change < - 0.5, p <0.0001) at each follow-up time point compared to baseline.Caregivers of participants with pre-existing asthma or dose-related respiratory allergic reactions had less improvement in HRQL than those who did not (p <0.01).Certain characteristics were associated with greater improvements in caregiver HRQL.

View Article: PubMed Central - PubMed

Affiliation: Stanford Alliance for Food Allergy Research, Palo Alto, CA USA ; Department of Pediatrics, Division of Immunology and Allergy, Stanford University, 269 Campus Drive, CCSR Building Suite 3215, Stanford, CA 94305 USA.

ABSTRACT

Background: Food allergy (FA) can have serious psychosocial and economic repercussions on food-allergic children and their caregivers and be associated with negative effects on their quality of life. Food allergen immunotherapy (IT) is a promising experimental therapy but can be linked to anxiety. This study investigated the effects of IT on FA-specific health-related quality of life (HRQL) over a 24 month-follow-up in caregivers of children with single and multiple food allergies. We hypothesized that characteristics such as age, asthma at baseline and respiratory allergic reactions during therapy were key characteristics that influenced HRQL scores.

Methods: A validated Food Allergy Quality of Life - Parental Burden Questionnaire (FAQL-PB) was used to assess HRQL. It was randomly distributed to and filled out by caregivers of 57 food-allergic children enrolled in clinical trials of IT. The same parent answered the FABQL-PB questionnaire at baseline and for 6-month, 12- month, 18- month, and 24-month time points on IT.

Results: Caregiver HRQL improved significantly (change < - 0.5, p <0.0001) at each follow-up time point compared to baseline. The percentages of caregivers with improvement in HRQL progressively increased (92% at 24 month-follow-up time point compared to baseline). HRQL improved more in caregivers of participants older than 10 years or desensitized to more than 4 food allergens than those who were not (p <0.0001). Caregivers of participants with pre-existing asthma or dose-related respiratory allergic reactions had less improvement in HRQL than those who did not (p <0.01).

Conclusion: IT lead to improvement in caregiver HRQL. Certain characteristics were associated with greater improvements in caregiver HRQL.

No MeSH data available.


Related in: MedlinePlus