Changes in Quality of Life of Food-Allergic Children during Up-Dosing of Oral Immunotherapy, Upon Reaching Maintenance, and After 6 months of Follow-up

Rationale. Data on changes in quality of life (QOL) of food-allergic children throughout the process of oral immunotherapy (OIT) is limited.

Methods. Parents of children aged 4-12 years undergoing OIT for food allergy completed the FAQLQ-Parental Form (FAQLQ-PF) at OIT initiation and upon reaching maintenance (n=158). A subgroup (n=85) completed the questionnaire also in mid up-dosing phase, and another subgroup (n=44) 6 months after reaching maintenance. Parents of age- and gender- matched food-allergic children not undergoing OIT, filled the FAQLQ-PF twice, with an interval of several months apart, and served as controls.

Results. Patients who reached maintenance phase (peanut, n=62; milk, n=56; tree-nuts, n=19; egg, n=12; sesame, n=9) had significantly improved (lower) FAQOL-PF scores compared to OIT initiation (Total score; 3.607 to 3.133 p<0.001, Emotional Impact (EI); 3.597 to 3.27 p=0.002, Food Anxiety (FA); 3.803 to 3.24 p<0.001, Social and Dietary Limitation (SDL); 3.415 to 2.815 p<0.001) while no change was noted in the control group between the 2 time points. Among patients examined in mid up-dosing, those with diminished FAQLQ-PF scores improved significantly upon reaching maintenance, while those with improved scores in mid up-dosing, improved further. Patients who filled the FAQLQ-PF six months after reaching maintenance showed additional significant improvement (Total; 3.266 to 2.614 P=0.001, EI; 3.414 to 2.993 P=0.049, FA; 3.37 to 2.593 P=0.001, SDL; 2.989 to 2.264 p=0.001).

Conclusions. QOL of food-allergic children improves significantly upon reaching OIT maintenance, with additional improvement 6 months later. The detrimental effect of OIT on some patients’ QOL during up-dosing is reversed upon reaching maintenance.