ArticleFrontiers in allergy2025
Efficacy and safety of a 4-step versus a 5-step egg ladder in children with IgE-mediated hen's egg protein allergy: protocol for an open-label randomized controlled trial.
Article in Frontiers in allergy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07040111 (Efficacy and Safety of a 4-Step Versus a 5-Step Egg Ladder in Children With IgE-Mediated Hen's Egg Protein Allergy), which is not on this map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy and Safety of a 4-Step Versus a 5-Step Egg Ladder in Children With IgE-Mediated Hen's Egg Protein Allergy: Protocol for an Open-Label Randomized Controlled Trial
Who cites it
1 citing paper in PubMed.
- Who fails the egg ladder? Predictors of reactions and clinical outcomes with individualized entry-step selection in 197 children with IgE-mediated egg allergy.European journal of pediatrics · 2026Article
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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Introducing baked egg into the diet of children with hen's egg allergy (HEA) has been shown to potentially accelerate the development of tolerance to non-heated egg. However, there is no standardized egg ladder (EL) protocol, and different scientific societies across countries recommend varying versions. This study aims to assess the efficacy and safety of the four-step EL (4-EL) compared with the five-step EL (5-EL) in children with IgE-mediated HEA. Methods: We will perform an open-label randomized trial with two-parallel arms in two departments if the same academic hospital. A total of 84 children with IgE-mediated HEA will be allocated in 1:1 ratio to introduce hen's egg allergy into their diet according to either 4-EL or 5-EL with 4-week break period between subsequent steps. Oral food challenge (OFC) with tested products at each subsequent step of the EL will be conducted in hospital settings. The primary outcome will be the percentage of children with tolerance to non-heated hen's egg proteins defined as non-allergic reaction to raw hen's egg (0.5-1 egg, depending on the age of the patient) during the last OFC; measured at the end of the 18-week observation period for the 4-EL and 24-week observation period for the 5-EL. Secondary outcomes will include the percentage of children with negative OFC to each EL step; the percentage of children with anaphylaxis (including the percentage of those who were treated with epinephrine); the percentage of children with exacerbation of atopic dermatitis; growth; compliance; and quality of life of the caregivers and parents anxiety about adverse events during their child's OFC. Discussion: This rigorously designed RCT will provide evidence on the efficacy and safety of the 4-EL in children with IgE-mediated HEA. The findings will inform guideline development groups and further confirmatory trials. Trial Registration Number: NCT07040111, date of registration: 27 June 2025.
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