Pooled Analysis of the Cow’s Milk-related-Symptom-Score (CoMiSSTM) as a Predictor for Cow’s Milk Related Symptoms
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Purpose: The diagnosis of cow’s milk (CM) allergy is a challenge. The Cow’s Milk-related-Symptom-Score (CoMiSSTM) was developed to offer primary health care providers a reliable diagnostic tool for CM related symptoms. The predictive prospective value of the CoMiSSTM was evaluated in three clinical trials. Methods: Pooled analyses of the three studies were conducted based on regressing the results of the month-1 chal-lenge test on the month-1 CoMiSSTM, adjusting for baseline CoMiSSTM using a logistic regression model. In addition a logistic regression model was also fitted to the month-1 challenge test result with the change in CoMiSSTM from baseline as a predictor. Results: Results suggest that infants having a low CoMiSSTM (median, 5) after 1 month dietary treatment free from intact CM protein have a significant risk of having a positive challenge test (odds ratio, 0.83; 95% confidence interval, 0.75-0.93; p=0.002). Pooled data suggest that the change in CoMiSSTM from baseline to month-1 can predict CM related symptoms as a confirmed diagnosis according to the challenge test at month-1. However, in order to validate such a tool, infants without CM related symptoms would also need to be enrolled in a validation trial. A concern is that it may not be ethical to expose healthy infants to a therapeutic formula and a challenge test.Conclusion: Pooled data analysis emphasizes that the CoMiSSTM has the potential to be of interest in infants sus-pected to have CM-related-symptoms. A prospective validation trial is needed.
Abstract
Purpose: The diagnosis of cow’s milk (CM) allergy is a challenge. The Cow’s Milk-related-Symptom-Score (CoMiSSTM) was developed to offer primary health care providers a reliable diagnostic tool for CM related symptoms. The predictive prospective value of the CoMiSSTM was evaluated in three clinical trials. Methods: Pooled analyses of the three studies were conducted based on regressing the results of the month-1 chal-lenge test on the month-1 CoMiSSTM, adjusting for baseline CoMiSSTM using a logistic regression model. In addition a logistic regression model was also fitted to the month-1 challenge test result with the change in CoMiSSTM from baseline as a predictor. Results: Results suggest that infants having a low CoMiSSTM (median, 5) after 1 month dietary treatment free from intact CM protein have a significant risk of having a positive challenge test (odds ratio, 0.83; 95% confidence interval, 0.75-0.93; p=0.002). Pooled data suggest that the change in CoMiSSTM from baseline to month-1 can predict CM related symptoms as a confirmed diagnosis according to the challenge test at month-1. However, in order to validate such a tool, infants without CM related symptoms would also need to be enrolled in a validation trial. A concern is that it may not be ethical to expose healthy infants to a therapeutic formula and a challenge test.Conclusion: Pooled data analysis emphasizes that the CoMiSSTM has the potential to be of interest in infants sus-pected to have CM-related-symptoms. A prospective validation trial is needed.
참고문헌 (6)
- Robbins KA, "Milk allergy is associated with decreased growth in US children", J Allergy Clin Immunol, 134, pp.1466~1468.e6 (2014)
- Vieira MC, "A survey on clinical presentation and nutritional status of infants with suspected cow' milk allergy", BMC Pediatr, 10, pp.25~ (2010)
- Vandenplas Y, "A workshop report on the development of the cow's milk-related symptom score awareness tool for young children", Acta Paediatr, 104, pp.334~339 (2015)
- Vandenplas Y, "Treating cow's milk protein allergy:a double-blind randomized trial comparing two extensively hydrolysed formulas with probiotics", Acta Paediatr, 102, pp.990~998 (2013)
- Vandenplas Y, "Safety and tolerance of a new extensively hydrolyzed rice protein-based formula in the management of infants with cow's milk protein allergy", Eur J Pediatr, 173, pp.1209~1216 (2014)
- Vandenplas Y, "Safety of a thickened extensive casein hydrolysate formula", Nutrition, 32, pp.206~212 (2016)