Meta AnalysisID 463
花生过敏患者口服免疫治疗临床效果的系统评价方案
CRD42018079891
To assess the clinical effectiveness of allergen specific peanut oral immunotherapy in the treatment of patients with confirmed peanut allergy.
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Record Fields
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- Meta Analysis Id
- 463
- Evidence Id
- 9021
- Core Evidence Id
- 9021
- Source Meta Analysis Id
- 438
- Herb2 Meta Analysis Id
- HBMA000438
- Crd Id
- CRD42018079891
- Title
- Proposal for a systematic review about the clinical effectiveness of oral immunotherapy in peanut allergic patients
- Review Question
- To assess the clinical effectiveness of allergen specific peanut oral immunotherapy in the treatment of patients with confirmed peanut allergy.
- Study Type Included
- This systematic review will consider RCT investigating OIT in patients with peanut allergy. In absence of RCT quasi RCT and controlled clinical trials (CCT) will be considered. Case series and case reports will be excluded from the review due to high potential of bias.
- Condition Being Studied
- The prevalence of IgE mediated peanut allergy has doubled in western populations in recent years. Severe and even fatal anaphylactic responses may be precipitated even by exposure to trace amount. Peanut allergy is rarely outgrown. Persistent fear of accidental exposure has markedly reduced quality of life of both patients and their families. Treatment is currently not available. One option under investigation is peanut oral immunotherapy (OIT). This consists of oral administration of escalating doses of peanut to peanut-allergic patients; followed by a maintenance dose for up to 3 years. Expected outcomes range from desensitization in which peanut is tolerated in patients maintained on regular peanut consumption, to tolerance in which unresponsiveness to peanut continue after stopping regular peanut ingestion. This review focusses on the clinical efficacy and safety of OIT in peanut allergic individuals.
- Participant
- Studies conducted on confirmed cases of IgE mediated peanut allergy of any degree of severity in either children or adults will be considered. Confirmed peanut allergy is defined as an allergic systemic reaction that involves one or more of the following systems: skin, eyes, upper or lower respiratory system, cardiovascular system, gastrointestinal system and central nervous system; that occurs within minutes to hours after peanut ingestion in sensitized individuals. Evidence of sensitization includes positive skin prick test (SPT) to peanut defined as a skin wheal ≥ 3mm than that of the normal saline control and/or positive peanut serum specific IgE as defined by the study group. There will be no restriction on age, race or ethnicity.
- Animal
- Human Disease Modelled
- Intervention
- We are interested in orally administered peanut immunotherapy of any type.
- Comparator Control
- We are interested in studies comparing peanut OIT to placebo or to dietary avoidance of peanut.
- Main Outcome
- 1. Evidence of desensitization defined as the ability to consume a pre-specified amount of peanut while undergoing OIT as demonstrated by an OFC performed at the end of the study. 2. Induction of immunologic tolerance defined as the ability to continue the consumption of the pre-specified amount of peanut 2 weeks or more after discontinuation of OIT as demonstrated by an OFC test performed 2 weeks or more after stopping OIT.
- Outcome Measure
- Additional Outcome
- 1. Improvement in quality of life assessed using a validated tool. 2. Safety of peanut OIT will be assessed by the frequency, type, severity and seriousness of allergic reactions precipitated by peanut OIT. A severe allergic reaction is defined as a reaction requiring epinephrine injection or hospitalization. A moderately severe allergic reaction is defined as a reaction necessitating treatment or medical consultation. A mild reaction is defined as a self-limited reaction or those requiring only the use of anti-histamine. In addition, reasons for withdrawal or exclusion from the studies due to OIT reaction will be assessed.
- Study Method
- Intervention, Systematic review
- Keyword
- Arachis; Humans; Immunotherapy; Peanut Hypersensitivity
- Contact
- Samar El Soda [email protected]
- Organisational Affiliation
- University of Southampton
- Funding Source
- No fund required
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- Country
- Review Stage
- Review Ongoing
- First Submission Date
- 2017-11-10
- Registration Date
- 2018-01-03
- Anticipated Start Date
- 2017-08-31
- Anticipated Completion Date
- 2018-06-30
- Title Cn
- 花生过敏患者口服免疫治疗临床效果的系统评价方案
- Title En
- Proposal for a systematic review about the clinical effectiveness of oral immunotherapy in peanut allergic patients
- Bilingual Status
- complete