Diagnosis and Rationale for Action Against Cow's Milk Allergy (DRACMA): a summary report |
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| Authors: | Fiocchi Alessandro Schünemann Holger J Brozek Jan Restani Patrizia Beyer Kirsten Troncone Riccardo Martelli Alberto Terracciano Luigi Bahna Sami L Rancé Fabienne Ebisawa Motohiro Heine Ralf G Assa'ad Amal Sampson Hugh Verduci Elvira Bouygue G R Baena-Cagnani Carlos Canonica Walter Lockey Richard F |
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| Affiliation: | a Department of Child and Maternal Medicine, Melloni Hospital, Milan, Italy;b Departments of Clinical Epidemiology and Biostatistics and of Medicine, McMaster University, Hamilton, Ontario, Canada;c Department of Pharmacological Sciences, Università degli Studi di Milano, Milan, Italy;d Charité Klinik für Pädiatrie m.S. Pneumologie und Immunologie, Berlin, Germany;e Department of Pediatrics, Federico II Hospital, University of Naples, Naples, Italy;f Paediatric Division, Department of Child and Maternal Medicine, University of Milan Medical School at the Melloni Hospital, Milan, Italy;g Pediatrics and Medicine, Allergy and Immunology, Louisiana State University Health Sciences Center, Shreveport, La;h Allergologie, Hôpital des Enfants, Pôle Médicochirurgical de Pédiatrie, Toulouse, France;i Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan;j Department of Allergy and Immunology, Royal Children's Hospital, University of Melbourne, Murdoch Childrens Research Institute, Melbourne, Australia;k Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio;l Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY;m Department of Pediatrics, University of Milan, Milan, Italy;n Division of Immunology and Respiratory Medicine, Department of Pediatrics, Infantile Hospital Cordoba, Cordoba, Argentina;o Allergy and Respiratory Diseases Clinic, Department of Internal Medicine, University of Genoa, Genoa, Italy;p Division of Allergy and Immunology, University of South Florida College of Medicine, Tampa, Fla |
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| Abstract: | ![]()
The 2nd Milan Meeting on Adverse Reactions to Bovine Proteins was the venue for the presentation of the first consensus-based approach to the management of cow's milk allergy. It was also the first time that the Grading of Recommendations, Assessments, Development, and Evaluation approach for formulating guidelines and recommendations was applied to the field of food allergy. In this report we present the contributions in allergen science, epidemiology, natural history, evidence-based diagnosis, and therapy synthesized in the World Allergy Organization Diagnosis and Rationale for Action against Cow's Milk Allergy guidelines and presented during the meeting. A?consensus emerged between discussants that cow's milk allergy management should reflect not only basic research but also a newer and better appraisal of the literature in the light of the values and preferences shared by patients and their caregivers in partnership. In the field of diagnosis, atopy patch testing and microarray technology have not yet evolved for use outside the research setting. With foreseeable breakthroughs (eg, immunotherapy and molecular diagnosis) in the offing, the step ahead in leadership can only stem from a worldwide organization implementing consensus-based clinical practice guidelines to diffuse and share clinical knowledge. |
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| Keywords: | Cow's milk allergy epidemiology amino acid formula hydrolyzed milk formula soy formula hydrolyzed rice formula skin prick test specific IgE oral immunotherapy Grading of Recommendations Assessments Development, and Evaluation approach |
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