Document Detail

The efficacy of amino acid-based formulas in relieving the symptoms of cow's milk allergy: a systematic review.
MedLine Citation:
PMID:  17517094     Owner:  NLM     Status:  MEDLINE    
The aim of this systematic review was to evaluate the efficacy of amino acid-based formulas (AAF) in patients with cow's milk allergy (CMA). Studies were identified using electronic databases and bibliography searches. Subjects eligible for inclusion were patients of any age with CMA or symptoms suggestive of it. Comparisons of interest were AAF vs. extensively hydrolysed formula (eHF), AAF vs. soy-based formula (SF) and AAF vs. cow's milk or cow's milk-based formula. Outcomes of interest were gastrointestinal (GI), dermatological, respiratory and behavioural symptoms as well as growth. A total of 20 studies [three head-to-head randomized controlled trials (RCTs), three cross-over challenge RCTs, seven clinical trials (CTs) and seven case reports (CRs)] were included in the review. In infants with confirmed or suspected CMA, the use of an AAF was shown to be safe and efficacious. Findings from RCT comparisons of AAF with eHF showed that both formulas are equally efficacious at relieving the symptoms of CMA in confirmed or suspected cases. However, infants in specific subgroups (e.g. non-IgE mediated food-induced gastro-enterocolitis-proctitis syndromes with failure to thrive, severe atopic eczema, or with symptoms during exclusive breastfeeding) were more likely overall to benefit from AAF, as intolerance to eHF may occur. In such cases, symptoms persisting despite eHF feeding usually remit on AAF, and catch-up growth may be seen. Meta-analysis of the findings was not possible due to lack of homogenous reporting of outcomes in the original trials. This systematic review shows clinical benefit from use of AAF in both symptoms and growth in infants and children with CMA who fail to tolerate eHF. Further studies are required to determine the relative medical or economic value of initial treatment with AAF in infants at high risk of eHF intolerance.
D J Hill; S H Murch; K Rafferty; P Wallis; C J Green
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology     Volume:  37     ISSN:  0954-7894     ISO Abbreviation:  Clin. Exp. Allergy     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-22     Completed Date:  2007-11-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8906443     Medline TA:  Clin Exp Allergy     Country:  England    
Other Details:
Languages:  eng     Pagination:  808-22     Citation Subset:  IM    
Department of Allergy, Royal Children's Hospital, Melbourne, Australia.
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MeSH Terms
Amino Acids* / adverse effects
Breast Feeding / adverse effects
Cross-Over Studies
Databases, Factual
Dermatitis, Atopic / diet therapy,  immunology,  pathology
Enteritis / diet therapy,  immunology,  pathology
Failure to Thrive / diet therapy,  immunology,  pathology
Immunoglobulin E / immunology
Infant Food* / adverse effects
Infant Formula*
Infant, Newborn
Meta-Analysis as Topic
Milk* / adverse effects
Milk Hypersensitivity* / diet therapy,  immunology,  pathology
Milk, Human*
Proctitis / diet therapy,  immunology,  pathology
Randomized Controlled Trials as Topic
Soy Milk*
Reg. No./Substance:
0/Amino Acids; 37341-29-0/Immunoglobulin E

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