Meta-analysis of a partially hydrolysed 100%-whey infant formula vs. extensively hydrolysed infant formulas in the prevention of atopic dermatitis

Abstract

Objectives:

This study presents previously unpublished point and cumulative incidence rates and relative risks (RRs) for comparing a partially hydrolysed 100% whey-based infant formula, NAN-HA^* (PHF-W) to extensively hydrolysed whey- (EHF-Whey) or casein-based (EHF-Casein) infant formulas in the prevention of atopic dermatitis (AD) in infants who cannot be breastfed exclusively. It also outlines methods to convert the above-mentioned data as well as data comparing PHF-W to cows’ milk formula (SF) into inputs to be applied to a pharmacoeconomic model.

* NAN-HA is a registered trade name of Nestlé SA, Switzerland.

Methods:

The incidence rates and RRs were obtained from a meta-analysis which analysed efficacy for PHF-W vs. EHF but did not present those. It took into consideration any relevant randomized controlled trial which compared the use of PHF-W with SF or EHF for the prevention of allergies. The primary outcomes of interest were the incidence, cumulative incidence and period prevalence of allergic manifestations and of AD in particular. Fifteen studies had been included for analysis of which six studies explored PHF-W vs. EHF. These results and PHF-W vs. SF data were adapted for inputs into a pharmacoeconomic model which used a spreadsheet decision-analytic economic model based on 3-month cycles to explore the cost-effectiveness of PHF-W vs. SF and EHF. Weights were applied to the incidence rates and RRs for each reported time period which were then adapted into 3-month indicators.

Results:

This meta-analysis for PHF-W (557 patients) vs. EHF-Whey (559 patients) yielded RR of 0.75 (0.54, 1.05) and 0.80 (0.63, 1.02) at 0–12 months and at 0–36 months, respectively. Corresponding RRs for PHF-W vs. EHF-Casein (580 patients) were 1.06 (0.74, 1.53) at 0–12 months and 1.13 (0.87, 1.47) at 0–36 months.

Conclusion:

It appears that the efficacy of PHF-W falls within the range of that of both EHF formulas (whey and casein) and allows the application of these results in a pharmacoeconomic model.

Key words::

• Allergy
• Atopic Dermatitis
• Children
• Infant Formula
• Meta-analysis
• Prevention
• Protein hydrolysates

Transparency

Declaration of funding

This study was funded by Nestlé Nutrition Institute (NNI).

Declaration of financial/other relationships

M.I., B.F. and J.B. are employed by PharmIdeas, which performed this study under contact with NNI; J.S. is employed by NNI. H.S. has received funding from NNI for research, speaking fees, consultancy and advisory committee participation.

Acknowledgements

We would like to thank Prof. Ferdinand Haschke for editorial input.

Notes

* NAN-HA is a registered trade name of Nestlé SA, Switzerland.

* NAN-HA is a registered trade name of Nestlé SA, Switzerland.