Changes in patient quality of life during oral immunotherapy for food allergy

Abstract

Background

Quality of life is (QOL) impaired in patients with food allergy and improves following oral immunotherapy (OIT). However, the treatment itself is prolonged and demanding. We examined changes in patient QOL during OIT for food allergy.

Methods

The FAQLQ-PF was administered to children aged 4-12 years undergoing OIT for milk, peanut or egg allergy, at the beginning and after 4 months of treatment. Patients were categorized as improved, unchanged, or diminished FAQLQ-PF (>0.5 point decrease, a change of ≤0.5 points, or >0.5 increase, respectively) and compared. Food-allergic patients not undergoing OIT served as controls.

Results

The Food Anxiety, Social and Dietary limitation and total FAQLQ-PF scores improved significantly during the study period (p=0.001, p=0.018 and p=0.01, respectively) in treated but not in control patients, while the Emotional Impact did not. The change in the FAQLQ-PF was independent of the maximal tolerated dose at baseline or following four months of treatment, the pace of dose-increase or of number or severity of reactions experienced. The total FAQLQ-PF score was inversely associated with the score at baseline on multi-variate analysis (regression coefficient = -0.56, p<0.001). That was driven primarily by improvement in QOL scores in patients with high score (worse QOL) at baseline. Some patients with low FAQLQ-PF score (better QOL) at baseline, deteriorated.

Conclusions

QOL of patients with food allergy improves in some but deteriorates in others during OIT. Patients with impaired QOL at baseline, improve significantly despite the treatment-burden. Some patients with better QOL at baseline, might deteriorate during OIT.

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