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Berg, A. von; Filipiak-Pittroff, B.; Schulz, H.; Hoffmann, U.; Link, E.; Sussmann, M.; Schnappinger, M.; Brüske, I.; Standl, M.; Krämer, U.; Hoffmann, B.; Heinrich, J.; Bauer, C.-P.; Koletzko, S.; Berdel, D. (2016): Allergic manifestation 15years after early intervention with hydrolyzed formulas - the GINI Study. In: Allergy, Vol. 71, No. 2: pp. 210-219
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Abstract

BackgroundData on the long-term impact of hydrolyzed formulas on allergies are scarce. ObjectiveTo assess the association between early intervention with hydrolyzed formulas in high-risk children and allergic outcomes in adolescence. MethodsGINI trial participants (n=2252) received one of four formulas in the first four months of life as breastmilk substitute if necessary: partial or extensive whey hydrolyzate (pHF-W, eHF-W), extensive casein hydrolyzate (eHF-C) or standard cows milk formula (CMF) as reference. Associations between these formulas and the cumulative incidence and prevalence of parent-reported physician-diagnosed asthma, allergic rhinitis (AR) and eczema, as well as spirometric indices and sensitization, were examined using generalized linear models. ResultsBetween 11 and 15years, the prevalence of asthma was reduced in the eHF-C group compared to CMF (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.26-0.89), which is consistent with the spirometric results. The cumulative incidence of AR was lower in eHF-C (risk ratio (RR) 0.77, 95% CI 0.59-0.99]) and the AR prevalence in pHF-W (OR 0.67, 95% CI 0.47-0.95) and eHF-C (OR 0.59, 95% CI 0.41-0.84). The cumulative incidence of eczema was reduced in pHF-W (RR 0.75, 95% CI 0.59-0.96) and eHF-C (RR 0.60, 95% CI 0.46-0.77), as was the eczema prevalence between 11 and 15years in eHF-C (OR 0.42, 95% CI 0.23-0.79). No significant effects were found in the eHF-W group on any manifestation,nor was there an effect on sensitization with any formula. ConclusionIn high-risk children, early intervention using different hydrolyzed formulas has variable preventative effects on asthma, allergic rhinitis and eczema up to adolescence.