title: Do Longer Intervals between Challenges Reduce the Risk of Adverse Reactions in Oral Wheat Challenges?
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To investigate the effect of ingestion methods on wheat allergy symptoms and treatment during OFCs.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  This study suggests that the 30-min interval method reduces the risk of adverse events, compared to the 15-min interval method.
authors.affiliation: Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Yanagida
authors.affiliation: Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Imai
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Sakura
authors.initials: S
authors.lastname: Sato
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Ebisawa
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007159:Immunologic Tests / Q000009:adverse effects* / Q000379:methods; D008297:Male; D012189:Retrospective Studies; D012306:Risk; D021182:Wheat Hypersensitivity / Q000175:diagnosis*