Evidence map›Paper›PMID 41263053›Full record

ArticleAllergy2026

Decreased Severity of Oral Immunotherapy Induced Gastrointestinal Eosinophilic Reactions Following Revisions in Milk-Treatment Protocol.

Na'ama Epstein-Rigbi, Matan Elkan, Yair Tzarfati, Michael B Levy, Liat Nachshon, Yael Koren, Yitzhak Katz, Arnon Elizur, Michael R Goldberg

Abstract read
In one paragraph

Article in Allergy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. The Food Allergy-Eosinophilic Esophagitis Continuum: Implications for Food Allergy Immunotherapy.The journal of allergy and clinical immunology. In practice · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Na'ama Epstein-RigbiInstitute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf Harofeh) Medical Center, Be'er Ya'akov, Israel.ORCID https://orcid.org/0000-0001-5321-1782
Matan ElkanInstitute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf Harofeh) Medical Center, Be'er Ya'akov, Israel.ORCID https://orcid.org/0000-0002-9523-5616
Yair TzarfatiDepartment of Medicine Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Michael B LevyInstitute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf Harofeh) Medical Center, Be'er Ya'akov, Israel.
Liat NachshonInstitute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf Harofeh) Medical Center, Be'er Ya'akov, Israel.ORCID https://orcid.org/0000-0003-4377-472X
Yael KorenInstitute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf Harofeh) Medical Center, Be'er Ya'akov, Israel.
Yitzhak KatzDepartment of Pediatrics, Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Arnon ElizurInstitute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf Harofeh) Medical Center, Be'er Ya'akov, Israel.ORCID https://orcid.org/0000-0001-8157-8143
Michael R GoldbergInstitute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf Harofeh) Medical Center, Be'er Ya'akov, Israel.

Funding

Leon Alcalay Chair in Pediatric Immunology, Tel Aviv UniversityMinistry of Health, Israel
6 · The paper itself

Abstract

backgroundOIT-induced gastrointestinal eosinophilic reactions (OITIGER) is comprised of abdominal pain/vomiting unrelated to the timing of dose administration, typically associated with increased absolute eosinophil counts (AEC). Previously described risk factors during milk OIT included higher baseline AEC, higher OIT starting dose (SD) and faster dose increase. The effect of a revised milk OIT protocol (lower SD and slower dose escalations), on the rate and severity of OITIGER, was examined.

methodsMilk OIT patients treated with a revised protocol between 2017 and 2021 (n = 269) were compared to a milk cohort from 2010 to 2015 (n = 604) who were treated with the previous protocol. OITIGER rate, severity, and treatment outcomes were compared.

resultsPatients in the revised protocol were slightly older (p < 0.001), but other demographics and baseline AEC were similar. The rates for OITIGER were comparable (8.2% vs. 9.1%). However, there was a significant reduction in the rate of severe presentation, defined by vomiting ≥ 3 times/month (45.5% vs. 72.7%, p = 0.023) among OITIGER patients undergoing the revised protocol. Upon multivariate logistic regression, baseline AEC > 600/μL was a risk factor [OR 2.16 (CI 1.30-3.60), p = 0.003] for OITIGER, while the revised protocol was protective for severe OITIGER [OR 0.30 (CI 0.10-0.89), p = 0.031]. Older age was associated with less OITIGER [OR 0.92 (CI 0.85-0.99), p = 0.018] and borderline less severe OITIGER [OR 0.85 (CI 0.72-1.00), p = 0.050]. A lower fold increase in AEC was observed in OITIGER patients in the revised protocol (2.25 [1.63-3.45] vs. 1.79 [1.34-2.11], p = 0.009).

conclusionsA revised protocol was associated with reduced AEC increase, and ameliorated the severity of OITIGER during OIT.

Indexed as

AllergensDesensitization, ImmunologicEosinophiliaMilkMilk HypersensitivityAdministration, OralAdolescentAdultAnimalsChildEosinophilsFemaleHumansLeukocyte CountMaleMiddle AgedAllergensdesensitizationfood allergyoral immunotherapyoral immunotherapy induced gastrointestinal eosinophilic reaction

Identifiers

PMID41263053
PMCPMC13040637

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.