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New England Journal of Medicine· 2016Q1· Klinik çalışma

Anne Sütü Alan Bebeklerde Alerjen Gıdaların Tanıtımına İlişkin Randomize Çalışma

Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants

Michael R. Perkin, Kirsty Logan, Anna Tseng, Bunmi Raji ve diğerleri

Kısa özet

Anne sütü alan bebeklere altı alerjen gıdanın (yer fıstığı, yumurta, süt, susam, balık, buğday) erken tanıtılması, niyet-tedavi analizinde gıda alerjisi oranlarını önemli ölçüde azaltmadı, ancak protokol analizinde faydalar gösterdi.

Yapay zekâ ile başlık ve abstract'tan üretildi; tam metin okunmaz.

Ana noktalar

  • Altı alerjen gıdanın erken tanıtılması, niyet-tedavi analizinde birincil son noktaya ulaşamadı (%7,1'e karşılık %5,6).
  • Protokol analizinde genel gıda alerjisi (%2,4'e karşılık %7,3), yer fıstığı alerjisi (%0'a karşılık %2,5) ve yumurta alerjisi (%1,4'e karşılık %5,5) anlamlı derecede daha düşük bulundu.
  • Haftada 2 gr yer fıstığı veya yumurta proteini tüketimi, ilgili alerjilerin daha düşük prevalansı ile ilişkilendirildi.
  • Erken tanıtım güvenliydi ancak tutarlı bir şekilde sağlanması zordu.

Yapay zekâ ile başlık ve abstract'tan üretildi; tam metin okunmaz.

Özet (abstract)

BACKGROUND: The age at which allergenic foods should be introduced into the diet of breast-fed infants is uncertain. We evaluated whether the early introduction of allergenic foods in the diet of breast-fed infants would protect against the development of food allergy. METHODS: We recruited, from the general population, 1303 exclusively breast-fed infants who were 3 months of age and randomly assigned them to the early introduction of six allergenic foods (peanut, cooked egg, cow's milk, sesame, whitefish, and wheat; early-introduction group) or to the current practice recommended in the United Kingdom of exclusive breast-feeding to approximately 6 months of age (standard-introduction group). The primary outcome was food allergy to one or more of the six foods between 1 year and 3 years of age. RESULTS: In the intention-to-treat analysis, food allergy to one or more of the six intervention foods developed in 7.1% of the participants in the standard-introduction group (42 of 595 participants) and in 5.6% of those in the early-introduction group (32 of 567) (P=0.32). In the per-protocol analysis, the prevalence of any food allergy was significantly lower in the early-introduction group than in the standard-introduction group (2.4% vs. 7.3%, P=0.01), as was the prevalence of peanut allergy (0% vs. 2.5%, P=0.003) and egg allergy (1.4% vs. 5.5%, P=0.009); there were no significant effects with respect to milk, sesame, fish, or wheat. The consumption of 2 g per week of peanut or egg-white protein was associated with a significantly lower prevalence of these respective allergies than was less consumption. The early introduction of all six foods was not easily achieved but was safe. CONCLUSIONS: The trial did not show the efficacy of early introduction of allergenic foods in an intention-to-treat analysis. Further analysis raised the question of whether the prevention of food allergy by means of early introduction of multiple allergenic foods was dose-dependent. (Funded by the Food Standards Agency and others; EAT Current Controlled Trials number, ISRCTN14254740.).

Yazarların özeti; kaynağından alınmıştır. New England Journal of Medicine, 2016 · DOI ↗

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Immunology and AllergyMedicine