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

Debra J Palmer, Thomas R Sullivan, Michael S Gold, Susan L Prescott, Maria Makrides

Journal: The Journal of allergy and clinical immunology 2017;139(5):1600-1607.e2

PMID: 27554812

Full Text on Elsevier Science View on PubMed

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 IgG levels were substantially higher in the egg group at 12 months (median, 1.22 mg/L vs control 0.07 mg/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.

Address: School of Paediatrics and Child Health, the University of Western Australia (M561), Perth, Australia; Women's & Children's Health Research Institute, Adelaide, Australia. Electronic address: [email protected].; School of Public Health, University of Adelaide, Adelaide, Australia.; School of Medicine, University of Adelaide, Women's and Children's Health Network, Adelaide, Australia.; School of Paediatrics and Child Health, the University of Western Australia (M561), Perth, Australia; Telethon Kids Institute, University of Western Australia, Perth, Australia.; Women's & Children's Health Research Institute, Adelaide, Australia; School of Medicine, University of Adelaide, Women's and Children's Health Network, Adelaide, Australia; Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, Australia.

DOI: 10.1016/j.jaci.2016.06.052

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MeSH Terms: Double-Blind Method, Egg Hypersensitivity, Egg Proteins, Eggs, Female, Humans, Immunoglobulin E, Infant, Male, Risk Factors