An interventional study of Cow's milk and Placebo in Cow Milk Allergy and Food Allergy, sponsored by Martini Hospital Groningen. Recruiting at 1 site in Netherlands. Open to participants aged 1 Month to 18 Months. Per ClinicalTrials.gov, last updated 2024-11-25.
Sponsored by Martini Hospital Groningen · Not applicable, Interventional, and Diagnostic
There are a lot of parents who believe that their child may not tolerate cow's milk because they develop symptoms such as redness of the skin or they may vomit. It is not always easy to find out if these infants should indeed avoid drinking cow's milk or that the symptoms are caused by something else, for instance because they have a viral illness. The goal of the investigators is to find out if cow's milk should be introduced in the hospital or if it can also be advised to perform the introduction at home to determine if an infant can drink cow's milk without developing symptoms. Half of the participants will drink cow's milk in the hospital. This test is performed on two days. On one of the days cow's milk will be offered. On the other day a look-alike substance is offered. The other half of the participants will drink cow's milk at home by starting to drink a little bit of milk and in a few steps drink a normal bottle of cow's milk. The main question is whether both tests can be used to find out if an infant can drink cow's milk without developing symptoms.
Cow's milk allergy (CMA) is the most common food allergy among infants. CMA can be divided into immunoglobin E (IgE) and non-IgE-mediated allergy. In case of IgE-mediated allergy, symptoms occur within two hours after ingestion, and are potentially life-threatening. In patients without sensitisation, symptoms may occur up to 48 hours after ingestion and predominantly affect the gastrointestinal tract and skin. The gold standard to diagnose a cow's milk allergy is to perform a double-blind placebo controlled food challenge (DBPCFC). Determination of DBPCFC outcome for non-IgE-mediated allergy can be challenging due to delayed presentation of symptoms after the DBPCFC has been performed. Furthermore, in the majority of infants with non-IgE-mediated cow's milk allergy, symptoms are mild and therefore introduction under medical supervision is superfluous. To date, there is no validated diagnostic to confirm a diagnosis of non-IgE-mediated cow's milk allergy and potential over diagnosis is due to the overlap of symptoms with other common diseases in infants.
The aim of this study is to compare the outcome of an adjusted DBPCFC and introduction at home of cow's milk for children with a suspected non-IgE-mediated cow's milk allergy
Patients with a suspected cow's milk allergy will be randomized to a DBPCFC or home introduction of cow's milk after sensitisation for cow's milk has been excluded and parents have not reported severe symptoms during introduction of cow's milk. Outcome of both introduction methods will be based on predefined criteria. For patients with a negative outcome of the test unrestricted exposure to cow's milk is recommended. In case of a positive outcome, parents are recommended to gradually increase the amount of cow's milk in their child's diet by means of the "milk ladder". During regular follow-up visits the investigators will inquire whether introduction of cow's milk is successful and if needed motivate parents to continue further introduction. Number of all consultations will be registered.
147 studies on the registry are indexed under Milk Hypersensitivity; 26 are open to participants now.
This study's planned enrollment of 120 is above the median of 68 across 95 interventional studies indexed under Milk Hypersensitivity.
Browse Milk Hypersensitivity studies →Martini Hospital Groningen is the lead sponsor of 14 studies on the registry; 4 are open to participants now.
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Exclusion Criteria:
Introduction of cow's milk by means of an adjusted double blind placebo controlled challenge test
Diagnostic Test: Cow's milk · Diagnostic Test: Placebo
Introduction of cow's milk by means of a standardized schedule
Diagnostic Test: Home introduction
clinical introduction of cow's milk
Also known as: Oral food challenge test
clinical introduction of placebo
Also known as: Oral food challenge test
home introduction of cow's milk
Number of participants with a positive or negative test
Positive (intolerant) or negative (tolerant) outcome of the introduction test
Time frame: Determined 1 week after start of the test
Regular milk consumption
Milk consumption is based on normal daily intake for age
Time frame: Determined 6 weeks after completion of the test
Percentage and type of reported symptoms
Reported symptoms are classified according to predefined criteria
Time frame: Determined 6 weeks after completion of the test
Healthcare utilisation during the study period
Healthcare utilisation is determined by evaluation of the number of physical and telephone consultations
Time frame: Determined 6 weeks after completion of the test
Plan to share: Yes — Study protocol and data will be shared upon request
Supporting information: Study protocol, Clinical study report
Time frame: Data will be analysed after all patients have ended the study period.
Access criteria: Request by mailing principal investigator
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Martini Hospital Groningen