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Article ; Online: Cost-effectiveness of infant hypoallergenic formulas to manage cow’s milk protein allergy in France

Ana Teresa Paquete / Rui Martins / Mark P. Connolly / Marie Meulle / Nítida Pastor / Grégoire Benoist / Patrick Tounian

Journal of Market Access & Health Policy, Vol 11, Iss

2023 Volume 1

Abstract: ABSTRACTBackground Clinician’s choice of hypoallergenic formulas in the first-line management of cow’s milk protein allergy (CMPA) should be informed by evidence on clinical efficacy and cost-effectiveness.Objective We compare the cost-effectiveness of ... ...

Abstract	ABSTRACTBackground Clinician’s choice of hypoallergenic formulas in the first-line management of cow’s milk protein allergy (CMPA) should be informed by evidence on clinical efficacy and cost-effectiveness.Objective We compare the cost-effectiveness of amino acid-based formula (AAF), extensively hydrolyzed casein formula with Lactobacillus rhamnosus Gorbach Goldin (EHCF+LGG), extensively hydrolyzed whey formula (EHWF), and rice hydrolyzed formula (RHF) in non-breastfed children in France.Methods Immunotolerance and atopic manifestations’ prevalence were based on a prospective non-randomized study with a 36-month follow-up. Resource utilization was sourced from a survey of French clinicians, and unit costs were based on national data. Costs and health consequences were discounted at 2.5% annually. Results were reported using the Collective and French National Health Insurance perspectives.Results Children receiving EHCF+LGG were predicted to require less healthcare resources, given their reduced prevalence of CMPA symptoms at 3 years. In the base case, EHCF+LGG led to savings of at least €674 per child compared to AAF, EHWF, and RHF at 3 years, from both perspectives. Nutrition had the highest economic burden in CMPA, driven by hypoallergenic formulas and dietetic replacements costs. Results were robust to one-way and probabilistic sensitivity analyses.Conclusions EHCF+LGG was associated with more symptom-free time, higher immune tolerance, and lower costs.
Keywords	Cow’s milk protein allergy ; Cost-effectiveness analysis ; child nutrition sciences ; milk substitutes ; France ; Public aspects of medicine ; RA1-1270 ; Business ; HF5001-6182
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Phytonutrient and Nutraceutical Action against COVID-19: Current Review of Characteristics and Benefits.

Pastor, Nitida / Collado, Maria Carmen / Manzoni, Paolo

Nutrients

2021 Volume 13, Issue 2

Abstract: The trend toward using phytonutrients and/or nutraceuticals (P/Ns) with the aim of impacting immune health has increased in recent years. The main reason is that properties of P/Ns are associated with possible immunomodulating effects in the prevention ... ...

Abstract	The trend toward using phytonutrients and/or nutraceuticals (P/Ns) with the aim of impacting immune health has increased in recent years. The main reason is that properties of P/Ns are associated with possible immunomodulating effects in the prevention and complementary treatment of viral diseases, including COVID-19 and other respiratory infections. In the present review, we assess the scientific plausibility of specific P/Ns for this purpose of preventative and therapeutic interventions against COVID-19, with an emphasis on safety, validity, and evidence of efficacy against other viruses. Five potential candidates have been identified after reviewing available studies (in silico, in vitro, and in vivo) in which certain flavonoids have demonstrated a potential for use as adjuvant therapeutic agents against viral infections, including COVID-19. As these are often better tolerated than pharmacological treatments, their use could be more widely considered if additional detailed studies can validate the existing evidence.
MeSH term(s)	COVID-19/prevention & control ; Dietary Supplements ; Humans ; Phytochemicals/pharmacology ; SARS-CoV-2 ; COVID-19 Drug Treatment
Chemical Substances	Phytochemicals
Language	English
Publishing date	2021-01-30
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu13020464
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Cost-effectiveness of infant hypoallergenic formulas to manage cow's milk protein allergy in France.

Paquete, Ana Teresa / Martins, Rui / Connolly, Mark P / Meulle, Marie / Pastor, Nítida / Benoist, Grégoire / Tounian, Patrick

Journal of market access & health policy

2022 Volume 11, Issue 1, Page(s) 2154418

Abstract: Background: Clinician's choice of hypoallergenic formulas in the first-line management of cow's milk protein allergy (CMPA) should be informed by evidence on clinical efficacy and cost-effectiveness.: Objective: We compare the cost-effectiveness of ... ...

Abstract	Background: Clinician's choice of hypoallergenic formulas in the first-line management of cow's milk protein allergy (CMPA) should be informed by evidence on clinical efficacy and cost-effectiveness. Objective: We compare the cost-effectiveness of amino acid-based formula (AAF), extensively hydrolyzed casein formula with Lactobacillus rhamnosus Gorbach Goldin (EHCF+LGG), extensively hydrolyzed whey formula (EHWF), and rice hydrolyzed formula (RHF) in non-breastfed children in France. Methods: Immunotolerance and atopic manifestations' prevalence were based on a prospective non-randomized study with a 36-month follow-up. Resource utilization was sourced from a survey of French clinicians, and unit costs were based on national data. Costs and health consequences were discounted at 2.5% annually. Results were reported using the Collective and French National Health Insurance perspectives. Results: Children receiving EHCF+LGG were predicted to require less healthcare resources, given their reduced prevalence of CMPA symptoms at 3 years. In the base case, EHCF+LGG led to savings of at least €674 per child compared to AAF, EHWF, and RHF at 3 years, from both perspectives. Nutrition had the highest economic burden in CMPA, driven by hypoallergenic formulas and dietetic replacements costs. Results were robust to one-way and probabilistic sensitivity analyses. Conclusions: EHCF+LGG was associated with more symptom-free time, higher immune tolerance, and lower costs.
Language	English
Publishing date	2022-12-10
Publishing country	United States
Document type	Journal Article
ISSN	2001-6689
ISSN	2001-6689
DOI	10.1080/20016689.2022.2154418
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Article ; Online: In the Age of Viral Pandemic, Can Ingredients Inspired by Human Milk and Infant Nutrition Be Repurposed to Support the Immune System?

Brink, Lauren R / Chichlowski, Maciej / Pastor, Nitida / Thimmasandra Narayanappa, Athmaram / Shah, Neil

Nutrients

2021 Volume 13, Issue 3

Abstract: In 2020, with the advent of a pandemic touching all aspects of global life, there is a renewed interest in nutrition solutions to support the immune system. Infants are vulnerable to infection and breastfeeding has been demonstrated to provide protection. ...

Abstract	In 2020, with the advent of a pandemic touching all aspects of global life, there is a renewed interest in nutrition solutions to support the immune system. Infants are vulnerable to infection and breastfeeding has been demonstrated to provide protection. As such, human milk is a great model for sources of functional nutrition ingredients, which may play direct roles in protection against viral diseases. This review aims to summarize the literature around human milk (lactoferrin, milk fat globule membrane, osteopontin, glycerol monolaurate and human milk oligosaccharides) and infant nutrition (polyunsaturated fatty acids, probiotics and postbiotics) inspired ingredients for support against viral infections and the immune system more broadly. We believe that the application of these ingredients can span across all life stages and thus apply to both pediatric and adult nutrition. We highlight the opportunities for further research in this field to help provide tangible nutrition solutions to support one's immune system and fight against infections.
MeSH term(s)	Adult ; COVID-19/immunology ; COVID-19/therapy ; Female ; Food Ingredients/analysis ; Functional Food/analysis ; Humans ; Immune System/virology ; Infant ; Infant Nutritional Physiological Phenomena/immunology ; Male ; Milk, Human/chemistry ; Nutrition Therapy/methods ; SARS-CoV-2/immunology
Chemical Substances	Food Ingredients
Language	English
Publishing date	2021-03-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu13030870
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Factors Associated with the Development of Immune Tolerance in Children with Cow's Milk Allergy.

Sánchez-Valverde, Félix / Etayo, Verónica / Gil, Francisco / Aznal, Elena / Martínez, Diana / Amézqueta, Ana / Mendizábal, Mikel / Galbete, Arkaitz / Pastor, Nítida / Vanderhoof, Jon

International archives of allergy and immunology

2019 Volume 179, Issue 4, Page(s) 290–296

Abstract: Introduction: Cow's milk allergy (CMA) is a common diagnosis in infants, requiring the exclusion of cow's milk until tolerance is recovered. In the present study, we aim to determine which factors are associated with the development of tolerance.: ... ...

Abstract	Introduction: Cow's milk allergy (CMA) is a common diagnosis in infants, requiring the exclusion of cow's milk until tolerance is recovered. In the present study, we aim to determine which factors are associated with the development of tolerance. Methods: Retrospective, observational study of subjects who underwent the same clinical follow-up methodology. We studied 245 cases of CMA (125 IgE-mediated and 120 non-IgE-mediated). The following variables were analysed: age at diagnosis, gender, type of delivery, type of feeding received, feeding during the first months of life, clinical features, and type of feed received as treatment: casein hydrolysates or casein hydrolysates with Lactobacillus rhamnosus GG (LGG). Results: Factors associated with earlier tolerance were non-IgE-mediated CMA (HR = 2.92; 95% CI: 2.20-3.88) and patients receiving casein hydrolysate with LGG (HR = 1.79; 95% CI: 1.33-2.42). Later tolerance was associated with caesarean delivery (HR = 0.78; 95% CI: 0.58-1.05) and breastfeeding for a period of at least 3 days (HR = 0.64; 95% CI: 0.44-0.93). The multivariate study shows that the type of formula (HR = 1.61; 95% CI: 1.19-2.18) and the type of CMA (HR = 2.82; 95% CI: 2.12-3.85) have an effect on the recovery time. Casein hydrolysates with LGG reduces the recovery time in IgE-mediated (HR = 1.88; 95% CI: 1.17-3.01) and non-IgE-mediated CMA (HR = 1.46; 95% CI: 0.98-2.17). Conclusions: Tolerance acquisition is faster in non-IgE-mediated CMA subjects and in those who received casein hydrolysate with LGG.
MeSH term(s)	Allergens/immunology ; Animals ; Caseins/therapeutic use ; Cattle ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Immune Tolerance ; Immunoglobulin E/metabolism ; Male ; Milk Hypersensitivity/diet therapy ; Milk Hypersensitivity/epidemiology ; Milk Hypersensitivity/immunology ; Milk Proteins/immunology ; Retrospective Studies ; Risk Factors ; Spain/epidemiology
Chemical Substances	Allergens ; Caseins ; Milk Proteins ; Immunoglobulin E (37341-29-0) ; casein hydrolysate (65072-00-6)
Language	English
Publishing date	2019-05-16
Publishing country	Switzerland
Document type	Journal Article ; Observational Study
ZDB-ID	1108932-5
ISSN	1423-0097 ; 1018-2438
ISSN (online)	1423-0097
ISSN	1018-2438
DOI	10.1159/000499319
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Infants fed formula with added long chain polyunsaturated fatty acids have reduced incidence of respiratory illnesses and diarrhea during the first year of life.

Lapillonne, Alexandre / Pastor, Nitida / Zhuang, Weihong / Scalabrin, Deolinda M F

BMC pediatrics

2014 Volume 14, Page(s) 168

Abstract: Background: Long chain polyunsaturated fatty acids (LCPUFAs) may influence the immune system. Our objective was to compare the frequency of common illnesses in infants who received formula with or without added LCPUFAs.: Methods: In this ... ...

Abstract	Background: Long chain polyunsaturated fatty acids (LCPUFAs) may influence the immune system. Our objective was to compare the frequency of common illnesses in infants who received formula with or without added LCPUFAs. Methods: In this observational, multi-center, prospective study, infants consumed formula with 17 mg DHA and 34 mg ARA/100 kcal (n = 233) or with no added DHA or ARA (n = 92). Pediatricians recorded respiratory illnesses, otitis media, eczema, and diarrhea through 1 year of age. Results: Infants who consumed formula with DHA/ARA had lower incidence of bronchitis/bronchiolitis (P = 0.004), croup (P = 0.044), nasal congestion (P = 0.001), cough (P = 0.014), and diarrhea requiring medical attention (P = 0.034). The odds ratio (OR) of having at least one episode of bronchitis/bronchiolitis (0.41, 95% CI 0.24, 0.70; P = 0.001), croup (0.23, 95% CI 0.05, 0.97; P = 0.045), nasal congestion (0.37, 95% CI 0.20, 0.66; P = 0.001), cough (0.52, 95% CI 0.32, 0.86; P = 0.011), and diarrhea requiring medical attention (0.51, 95% CI 0.28, 0.92; P = 0.026) was lower in infants fed DHA/ARA. The OR of an increased number of episodes of bronchitis/bronchiolitis, croup, nasal congestion, cough, and diarrhea, as well as the hazard ratio for shorter time to first episode of bronchitis/bronchiolitis, nasal congestion, cough, and diarrhea were also significantly lower in the DHA/ARA group. Conclusions: In healthy infants, formula with DHA/ARA was associated with lower incidence of common respiratory symptoms and illnesses, as well as diarrhea.
MeSH term(s)	Arachidonic Acid ; Diarrhea/epidemiology ; Diarrhea/prevention & control ; Docosahexaenoic Acids ; Eczema/epidemiology ; Eczema/prevention & control ; Female ; Follow-Up Studies ; Humans ; Incidence ; Infant ; Infant Formula ; Logistic Models ; Male ; Odds Ratio ; Otitis Media/epidemiology ; Otitis Media/prevention & control ; Prospective Studies ; Respiratory Tract Infections/epidemiology ; Respiratory Tract Infections/prevention & control
Chemical Substances	Docosahexaenoic Acids (25167-62-8) ; Arachidonic Acid (27YG812J1I)
Language	English
Publishing date	2014-07-02
Publishing country	England
Document type	Comparative Study ; Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2041342-7
ISSN	1471-2431 ; 1471-2431
ISSN (online)	1471-2431
ISSN	1471-2431
DOI	10.1186/1471-2431-14-168
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Factors Associated with the Development of Immune Tolerance in Children with Cow’s Milk Allergy

Sánchez-Valverde, Félix / Etayo, Verónica / Gil, Francisco / Aznal, Elena / Martínez, Diana / Amézqueta, Ana / Mendizábal, Mikel / Galbete, Arkaitz / Pastor, Nítida / Vanderhoof, Jon

International Archives of Allergy and Immunology

2019 Volume 179, Issue 4, Page(s) 290–296

Abstract: Introduction: Cow’s milk allergy (CMA) is a common diagnosis in infants, requiring the exclusion of cow’s milk until tolerance is recovered. In the present study, we aim to determine which factors are associated with the development of tolerance. Methods: ...

Institution	Gastroenterology and Paediatric Nutrition Section, Hospital Complex of Navarra, Pamplona, Spain Study Group of Nutrition and Paediatric Digestive Diseases of Navarra, GENDINA, Navarra-Biomed, IDISNA, Pamplona, Spain Statistical Service, Navarra-Biomed, IDISNA, RSSIEC, Navarre Health Service, Pamplona, Spain Mead Johnson Nutrition, Boston, Massachusetts, USA Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
Abstract	Introduction: Cow’s milk allergy (CMA) is a common diagnosis in infants, requiring the exclusion of cow’s milk until tolerance is recovered. In the present study, we aim to determine which factors are associated with the development of tolerance. Methods: Retrospective, observational study of subjects who underwent the same clinical follow-up methodology. We studied 245 cases of CMA (125 IgE-mediated and 120 non-IgE-mediated). The following variables were analysed: age at diagnosis, gender, type of delivery, type of feeding received, feeding during the first months of life, clinical features, and type of feed received as treatment: casein hydrolysates or casein hydrolysates with Lactobacillus rhamnosus GG (LGG). Results: Factors associated with earlier tolerance were non-IgE-mediated CMA (HR = 2.92; 95% CI: 2.20–3.88) and patients receiving casein hydrolysate with LGG (HR = 1.79; 95% CI: 1.33–2.42). Later tolerance was associated with caesarean delivery (HR = 0.78; 95% CI: 0.58–1.05) and breastfeeding for a period of at least 3 days (HR = 0.64; 95% CI: 0.44–0.93). The multivariate study shows that the type of formula (HR = 1.61; 95% CI: 1.19–2.18) and the type of CMA (HR = 2.82; 95% CI: 2.12–3.85) have an effect on the recovery time. Casein hydrolysates with LGG reduces the recovery time in IgE-mediated (HR = 1.88; 95% CI: 1.17–3.01) and non-IgE-mediated CMA (HR = 1.46; 95% CI: 0.98–2.17). Conclusions: Tolerance acquisition is faster in non-IgE-mediated CMA subjects and in those who received casein hydrolysate with LGG.
Keywords	Probiotics ; Casein hydrolysate ; Caesarean delivery
Language	English
Publishing date	2019-05-16
Publisher	S. Karger AG
Publishing place	Basel, Switzerland
Document type	Article
Note	Clinical Allergy – Research Article
ZDB-ID	1108932-5
ISSN	1423-0097 ; 1018-2438
ISSN (online)	1423-0097
ISSN	1018-2438
DOI	10.1159/000499319
Database	Karger publisher's database

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Article: Infants fed docosahexaenoic acid- and arachidonic acid-supplemented formula have decreased incidence of bronchiolitis/bronchitis the first year of life.

Pastor, Nitida / Soler, Begoña / Mitmesser, Susan Hazels / Ferguson, Paul / Lifschitz, Carlos

Clinical pediatrics

2006 Volume 45, Issue 9, Page(s) 850–855

Abstract: To assess the effect of docosahexaenoic acid and arachidonic acid supplementation in infant formula on the incidence of respiratory illnesses, pediatricians assigned infants to receive docosahexaenoic acid/arachidonic acid-supplemented formula or control ...

Abstract	To assess the effect of docosahexaenoic acid and arachidonic acid supplementation in infant formula on the incidence of respiratory illnesses, pediatricians assigned infants to receive docosahexaenoic acid/arachidonic acid-supplemented formula or control formula. Anthropometrics, medical history, and illnesses were reported. Among 1342 infants, there was a higher incidence of bronchiolitis in control versus docosahexaenoic acid/arachidonic acid-supplemented groups at 5, 7, and 9 months (P < .01). Weight, length, and head circumference were similar for both groups. Infants fed formula supplemented with 0.32% docosahexaenoic acid and 0.64% arachidonic acid experienced a lower incidence of bronchiolitis compared with infants fed formula supplemented with no docosahexaenoic acid/arachidonic acid or lower levels of docosahexaenoic acid/arachidonic acid in the first year of life.
MeSH term(s)	Anthropometry ; Arachidonic Acid/administration & dosage ; Bronchiolitis/epidemiology ; Bronchiolitis/prevention & control ; Bronchitis/epidemiology ; Bronchitis/prevention & control ; Confounding Factors (Epidemiology) ; Controlled Clinical Trials as Topic ; Dietary Supplements ; Docosahexaenoic Acids/administration & dosage ; Female ; Follow-Up Studies ; Humans ; Incidence ; Infant ; Infant Formula ; Male ; Prospective Studies ; Rhinitis/epidemiology ; Rhinitis/prevention & control ; Spain/epidemiology ; Time Factors
Chemical Substances	Docosahexaenoic Acids (25167-62-8) ; Arachidonic Acid (27YG812J1I)
Language	English
Publishing date	2006-11
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	207678-0
ISSN	1938-2707 ; 0009-9228
ISSN (online)	1938-2707
ISSN	0009-9228
DOI	10.1177/1073858406289801
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Cost-effectiveness of infant hypoallergenic formulas to manage cow’s milk protein allergy in France

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Article ; Online: Phytonutrient and Nutraceutical Action against COVID-19: Current Review of Characteristics and Benefits.

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Article: Cost-effectiveness of infant hypoallergenic formulas to manage cow's milk protein allergy in France.

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Article ; Online: In the Age of Viral Pandemic, Can Ingredients Inspired by Human Milk and Infant Nutrition Be Repurposed to Support the Immune System?

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Article ; Online: Factors Associated with the Development of Immune Tolerance in Children with Cow's Milk Allergy.

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Article ; Online: Infants fed formula with added long chain polyunsaturated fatty acids have reduced incidence of respiratory illnesses and diarrhea during the first year of life.

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Article: Factors Associated with the Development of Immune Tolerance in Children with Cow’s Milk Allergy

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Article: Infants fed docosahexaenoic acid- and arachidonic acid-supplemented formula have decreased incidence of bronchiolitis/bronchitis the first year of life.

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