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2. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guideline update – XI – Milk supplement/replacement formulas for infants and toddlers with CMA – Systematic review

Author

Bognanni, Antonio, Firmino, Ramon T., Arasi, Stefania, Chu, Derek K., Chu, Alexandro W.L., Waffenschmidt, Siw, Agarwal, Arnav, Dziechciarz, Piotr, Horvath, Andrea, Mihara, Hanako, Roldan, Yetiani, Terracciano, Luigi, Martelli, Alberto, Starok, Anna, Said, Maria, Shamir, Raanan, Ansotegui, Ignacio J., Dahdah, Lamia, Ebisawa, Motohiro, Galli, Elena, Kamenwa, Rose, Lack, Gideon, Li, Haiqi, Pawankar, Ruby, Warner, Amena, Wong, Gary Wing Kin, Bozzola, Martin, Assa'Ad, Amal, Dupont, Christophe, Bahna, Sami, Spergel, Jonathan, Venter, Carina, Szajewska, Hania, Nowak-Wegrzyn, Anna H., Vandenplas, Yvan, Papadopoulos, Nikolaos G., Waserman, Susan, Fiocchi, Alessandro, Schünemann, Holger J., and Brożek, Jan L.

Published
2024
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3. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guideline update – XII – Recommendations on milk formula supplements with and without probiotics for infants and toddlers with CMA

Author

Bognanni, Antonio, Fiocchi, Alessandro, Arasi, Stefania, Chu, Derek K., Ansotegui, Ignacio, Assa'ad, Amal H., Bahna, Sami L., Berni Canani, Roberto, Bozzola, Martin, Dahdah, Lamia, Dupont, Christophe, Dziechciarz, Piotr, Ebisawa, Motohiro, Firmino, Ramon T., Chu, Alexandro, Galli, Elena, Horvath, Andrea, Kamenwa, Rose, Lack, Gideon, Li, Haiqi, Martelli, Alberto, Nowak-Węgrzyn, Anna, Papadopoulos, Nikolaos G., Pawankar, Ruby, Roldan, Yetiani, Said, Maria, Sánchez-Borges, Mario, Shamir, Raanan, Spergel, Jonathan M., Szajewska, Hania, Terracciano, Luigi, Vandenplas, Yvan, Venter, Carina, Waffenschmidt, Siw, Waserman, Susan, Warner, Amena, Wong, Gary W.K., Schünemann, Holger J., and Brozek, Jan L.

Published
2024
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7. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guideline update – XIII – Oral immunotherapy for CMA – Systematic review

Author

Ansotegui, Ignacio J., Arasi, Stefania, Assa'ad, Amal H., Bahna, Sami L., Canani, Roberto Berni, Bognanni, Antonio, Bozzola, Martin, Brozek, Jan, Chu, Derek K., Dahdah, Lamia, Dupont, Christophe, Ebisawa, Motohiro, Fiocchi, Alessandro, Firmino, Ramon Targino, Galli, Elena, Kamenwa, Rose, Lack, Gideon, Li, Haiqi, Martelli, Alberto, Nowak-Wegrzyn, Anna H., Papadopoulos, Nikolaos G., Pawankar, Ruby, Said, Maria, Sánchez-Borges, Mario, Schünemann, Holger J., Shamir, Raanan, Spergel, Jonathan M., Szajewska, Hania, Terracciano, Luigi, Vandenplas, Yvan, Venter, Carina, Warner, Amena, Waserman, Susan, Wong, GaryW.K., Firmino, Ramon T., Waffenschmidt, Siw, Agarwal, Arnav, Dziechciarz, Piotr, Horvath, Andrea, Jebai, Rime, Mihara, Hanako, Roldan, Yetiani, Bahna, Sami, and Brożek, Jan L.

Published
2022
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8. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guideline update – XIV – Recommendations on CMA immunotherapy

Author

Brozek, Jan L., Firmino, Ramon T., Bognanni, Antonio, Arasi, Stefania, Ansotegui, Ignacio, Assa'ad, Amal H., Bahna, Sami L., Canani, Roberto Berni, Bozzola, Martin, Chu, Derek K., Dahdah, Lamia, Dupont, Christophe, Dziechciarz, Piotr, Ebisawa, Motohiro, Galli, Elena, Horvath, Andrea, Kamenwa, Rose, Lack, Gideon, Li, Haiqi, Martelli, Alberto, Nowak-Węgrzyn, Anna, Papadopoulos, Nikolaos G., Pawankar, Ruby, Roldan, Yetiani, Said, Maria, Sánchez-Borges, Mario, Shamir, Raanan, Spergel, Jonathan M., Szajewska, Hania, Terracciano, Luigi, Vandenplas, Yvan, Venter, Carina, Waffenschmidt, Siw, Waserman, Susan, Warner, Amena, Wong, Gary W.K., Fiocchi, Alessandro, and Schünemann, Holger J.

Published
2022
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10. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guideline update – XIII – Oral immunotherapy for CMA – Systematic review

Author

Bognanni, Antonio, primary, Chu, Derek K., additional, Firmino, Ramon T., additional, Arasi, Stefania, additional, Waffenschmidt, Siw, additional, Agarwal, Arnav, additional, Dziechciarz, Piotr, additional, Horvath, Andrea, additional, Jebai, Rime, additional, Mihara, Hanako, additional, Roldan, Yetiani, additional, Said, Maria, additional, Shamir, Raanan, additional, Bozzola, Martin, additional, Bahna, Sami, additional, Fiocchi, Alessandro, additional, Waserman, Susan, additional, Schünemann, Holger J., additional, Brożek, Jan L., additional, Ansotegui, Ignacio J., additional, Assa'ad, Amal H., additional, Bahna, Sami L., additional, Canani, Roberto Berni, additional, Bognanni, Antonio, additional, Brozek, Jan, additional, Dahdah, Lamia, additional, Dupont, Christophe, additional, Ebisawa, Motohiro, additional, Firmino, Ramon Targino, additional, Galli, Elena, additional, Kamenwa, Rose, additional, Lack, Gideon, additional, Li, Haiqi, additional, Martelli, Alberto, additional, Nowak-Wegrzyn, Anna H., additional, Papadopoulos, Nikolaos G., additional, Pawankar, Ruby, additional, Sánchez-Borges, Mario, additional, Spergel, Jonathan M., additional, Szajewska, Hania, additional, Terracciano, Luigi, additional, Vandenplas, Yvan, additional, Venter, Carina, additional, Warner, Amena, additional, and Wong, GaryW.K., additional

Published
2022
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11. In-Hospital Macro-, Meso-, and Micro-Drivers and Interventions for Antibiotic Use and Resistance: A Rapid Evidence Synthesis of Data from Canada and Other OECD Countries

Author

Stalteri Mastrangelo, Rosa, primary, Hajizadeh, Anisa, additional, Piggott, Thomas, additional, Loeb, Mark, additional, Wilson, Michael, additional, Lozano, Luis Enrique Colunga, additional, Roldan, Yetiani, additional, El-Khechen, Hussein, additional, Miroshnychenko, Anna, additional, Thomas, Priya, additional, Schünemann, Holger J., additional, and Nieuwlaat, Robby, additional

Published
2022
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12. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guideline update - XIV - Recommendations on CMA immunotherapy

Author

Jan L. Brozek, Ramon T. Firmino, Antonio Bognanni, Stefania Arasi, Ignacio Ansotegui, Amal H. Assa'ad, Sami L. Bahna, Roberto Berni Canani, Martin Bozzola, Derek K. Chu, Lamia Dahdah, Christophe Dupont, Piotr Dziechciarz, Motohiro Ebisawa, Elena Galli, Andrea Horvath, Rose Kamenwa, Gideon Lack, Haiqi Li, Alberto Martelli, Anna Nowak-Węgrzyn, Nikolaos G. Papadopoulos, Ruby Pawankar, Yetiani Roldan, Maria Said, Mario Sánchez-Borges, Raanan Shamir, Jonathan M. Spergel, Hania Szajewska, Luigi Terracciano, Yvan Vandenplas, Carina Venter, Siw Waffenschmidt, Susan Waserman, Amena Warner, Gary W.K. Wong, Alessandro Fiocchi, Holger J. Schünemann, Clinical sciences, Growth and Development, Pediatrics, Brozek, Jan L, Firmino, Ramon T, Bognanni, Antonio, Arasi, Stefania, Ansotegui, Ignacio, Assa'Ad, Amal H, Bahna, Sami L, Canani, Roberto Berni, Bozzola, Martin, Chu, Derek K, Dahdah, Lamia, Dupont, Christophe, Dziechciarz, Piotr, Ebisawa, Motohiro, Galli, Elena, Horvath, Andrea, Kamenwa, Rose, Lack, Gideon, Li, Haiqi, Martelli, Alberto, Nowak-Węgrzyn, Anna, Papadopoulos, Nikolaos G, Pawankar, Ruby, Roldan, Yetiani, Said, Maria, Sánchez-Borges, Mario, Shamir, Raanan, Spergel, Jonathan M, Szajewska, Hania, Terracciano, Luigi, Vandenplas, Yvan, Venter, Carina, Waffenschmidt, Siw, Waserman, Susan, Warner, Amena, Wong, Gary W K, Fiocchi, Alessandro, and Schünemann, Holger J

Subjects
Pulmonary and Respiratory Medicine, GRADE, Nutrition and Dietetics, Immunology, food and beverages, gastroenterology, Immunology and Allergy, immunotherapy, Pediatrics, Perinatology, and Child Health, milk allergy, Practice Guidelines
Abstract

Background: The prevalence of cow's milk allergy (CMA) is approximately 2-4.5% in infants and less than 0.5% in adults. Most children outgrow cow's milk allergy in early childhood, particularly that to the baked milk products. Immunotherapy with unheated cow's milk has been used as a treatment option for those who have not yet outgrown CMA, but the benefits must be balanced with the adverse effects. Objective: These evidence-based guidelines from the World Allergy Organization (WAO) intend to support patients, clinicians, and others in decisions about the use of oral and epicutaneous immunotherapy for the treatment of IgE-mediated CMA. Methods: WAO formed a multidisciplinary guideline panel balanced to include the views of all stakeholders and to minimize potential biases from competing interests. The McMaster University GRADE Centre supported the guideline-development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used, including GRADE Evidence-to-Decision frameworks, which were subject to public comment. Results: After a careful review of the summarized evidence and thorough discussions the WAO guideline panel suggests: a) using oral immunotherapy with unheated cow's milk in those individuals with confirmed IgE-mediated CMA who value the ability to consume controlled quantities of milk more than avoiding the large adverse effects of therapy, b) not using oral immunotherapy with unheated cow's milk in those who value avoiding large adverse effects of therapy more than the ability to consume controlled quantities of milk, c) using omalizumab in those starting oral immunotherapy with unheated cow's milk, d) not using oral immunotherapy with baked cow's milk in those who do not tolerate both unheated and baked milk, and e) not using epicutaneous immunotherapy outside of a research setting. The recommendations are labeled "conditional" due to the low certainty about the health effects based on the available evidence. Conclusions: Clinicians, patients, and their family members might want to discuss all the potential desirable and undesirable effects of oral immunotherapy for IgE-mediated CMA and integrate them with the patients' values and preferences before deciding on a treatment option. More robust research is needed to determine with greater certainty which interventions are likely to be the most beneficial with the least harms, and to develop safer, low-cost, and equitable treatments.

Published
2022

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