Dupont C , Kalach N , Soulaines P , Bradatan E , Lachaux A , Payot F , de Blay F , Guenard-Bilbault L , Hatahet R , Mulier S. - 46062 N - Paediatr Drugs 2014 ; 16(6) : 513-522.

A Thickened Amino-Acid Formula in Infants with Cow's Milk Allergy Failing to Respond to Protein Hydrolysate Formulas: A Randomized Double-Blind Trial

INTRODUCTION: Amino-acid-based formulas (AAFs) are recommended for children with cow’s milk protein allergy (CMPA) failing to respond to extensively hydrolyzed formulas (eHFs).
OBJECTIVE: This study aimed to assess the tolerance/hypoallergenicity and efficacy of a thickened AAF (TAAF) in these infants.
METHODS: This multicenter, double-blind, randomized controlled trial (NCT01940068) compared 3-month feeding with a pectin-based TAAF (Novalac((R)), United Pharmaceuticals, Paris, France) and a commercially available “reference” AAF (RAAF; Neocate((R)), Nutricia, Germany) in infants aged <18 months with CMPA and persistent allergy symptoms with eHF feeding. Reported here are the results of an interim analysis after 1 month of feeding.
RESULTS: Of the 86 infants randomized, CMPA with eHF intolerance was confirmed in 75 infants; all of them tolerated the allocated AAFs. The major allergic symptom disappeared within 1 month in 61.9 and 51.5 % and regurgitations disappeared in 66.7 and 42.3 % of infants who received TAAF and RAAF, respectively. Infants had significantly more normal stools (soft or formed consistency) with the TAAF (90.5 vs. 66.7 %; p = 0.011). From baseline, daily family life significantly improved with both AAFs: crying time decreased by 97.3 (p < 0.001) and 28.6 min (p = 0.014) and sleeping time increased by 64.6 (p = 0.009) and 29.0 min with TAAF and RAAF, respectively. At day 30, weight and body mass index z-score gains were 0.1 and 0.2 with TAAF and 0.2 and 0.0 with RAAF.
CONCLUSION: Both AAFs were well tolerated by infants with CMPA and eHF intolerance and ensured appropriate growth, with the TAAF providing additional comfort.