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Randomized Controlled Trial
. 2017 May;139(5):1600-1607.e2.
doi: 10.1016/j.jaci.2016.06.052. Epub 2016 Aug 20.

Randomized controlled trial of early regular egg intake to prevent egg allergy

Affiliations
Randomized Controlled Trial

Randomized controlled trial of early regular egg intake to prevent egg allergy

Debra J Palmer et al. J Allergy Clin Immunol. 2017 May.

Abstract

Background: The ideal age to introduce egg into the infant diet has been debated for the past 2 decades in the context of rising rates of egg allergy.

Objective: We sought to determine whether regular consumption of egg protein from age 4 to 6 months reduces the risk of IgE-mediated egg allergy in infants with hereditary risk, but without eczema.

Methods: Infants aged 4 to 6 months were randomly allocated to receive daily pasteurized raw whole egg powder (n = 407) or a color-matched rice powder (n = 413) to age 10 months. All infants followed an egg-free diet and cooked egg was introduced to both groups at age 10 months. The primary outcome was IgE-mediated egg allergy defined by a positive pasteurized raw egg challenge and egg sensitization at age 12 months.

Results: There was no difference between groups in the percentage of infants with IgE-mediated egg allergy (egg 7.0% vs control 10.3%; adjusted relative risk, 0.75; 95% CI, 0.48-1.17; P = .20). A higher proportion of participants in the egg group stopped taking the study powder because of a confirmed allergic reaction (25 of 407 [6.1%] compared with 6 of 413 [1.5%]). Egg-specific IgG4 levels were substantially higher in the egg group at 12 months (median, 1.22 mgA/L vs control 0.07 mgA/L; P < .0001).

Conclusions: We found no evidence that regular egg intake from age 4 to 6 months substantially alters the risk of egg allergy by age 1 year in infants who are at hereditary risk of allergic disease and had no eczema symptoms at study entry.

Keywords: Allergy prevention; complementary feeding; egg; food allergy; hereditary risk; oral tolerance; randomized controlled trial.

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Comment in

  • Timing of regular egg intake for prevention of egg allergy.
    Jiang WH, Deng L, Ye QJ, Cai JR, Cai XR, Li X. Jiang WH, et al. J Allergy Clin Immunol. 2018 Jan;141(1):459-460. doi: 10.1016/j.jaci.2017.09.017. Epub 2017 Nov 14. J Allergy Clin Immunol. 2018. PMID: 29146009 No abstract available.
  • Reply.
    Palmer DJ, Prescott SL, Makrides M. Palmer DJ, et al. J Allergy Clin Immunol. 2018 Jan;141(1):460-461. doi: 10.1016/j.jaci.2017.09.021. Epub 2017 Nov 14. J Allergy Clin Immunol. 2018. PMID: 29146011 No abstract available.

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