title: Multiple-allergen oral immunotherapy improves quality of life in caregivers of food-allergic pediatric subjects.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Stanford Alliance for Food Allergy Research, Palo Alto, CA, USA.
authors.forename: Iris M
authors.initials: IM
authors.lastname: Otani
authors.affiliation: Stanford Alliance for Food Allergy Research, Palo Alto, CA, USA.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bégin
authors.affiliation: Stanford Alliance for Food Allergy Research, Palo Alto, CA, USA.
authors.forename: Clare
authors.initials: C
authors.lastname: Kearney
authors.affiliation: Stanford Alliance for Food Allergy Research, Palo Alto, CA, USA.
authors.forename: Tina Lr
authors.initials: TL
authors.lastname: Dominguez
authors.affiliation: Stanford Alliance for Food Allergy Research, Palo Alto, CA, USA.
authors.forename: Anjuli
authors.initials: A
authors.lastname: Mehrotra
authors.affiliation: Stanford Alliance for Food Allergy Research, Palo Alto, CA, USA.
authors.forename: Liane R
authors.initials: LR
authors.lastname: Bacal
authors.affiliation: Stanford Alliance for Food Allergy Research, Palo Alto, CA, USA.
authors.forename: Shruti
authors.initials: S
authors.lastname: Wilson
authors.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, California 94305, USA.
authors.forename: Kari
authors.initials: K
authors.lastname: Nadeau
keywords: Anti-IgE; Food allergy; Health-related quality of life; Omalizumab; Oral desensitization; Oral immunotherapy; Quality of life