Ketotifen, benzocycloheptathiophene, (
Zaditen) an orally active,
anti-allergic and
anti-asthmatic drug in a dose of 1 mg twice daily was given from 2 to 20 months in 20 selected patients with
food allergy (FA) or
food intolerance (FI). Sixteen children and four adults of which ten had
atopic dermatitis (AD), six
urticaria or/and angiooedema (two of which with oropharynx
pruritus, oedema of the lips and
anaphylactic shock), two
asthma, and two
gastrointestinal disorders.
Food allergy was proved by clinical history, exclusion diet positive challenge test, skin prick tests (SPT) total
IgE (PRIST) and specific
IgE (RAST). Gastrointestinal permeability was measured in 5 out of 20 patients using
mannitol and
lactulose as probe molecules on three occasions: (1) by ingestion of the markers alone, (2) with concomitant ingestion of the offending food(s), and (3) with previous administration of
ketotifen (2 mg) six hours before ingestion of markers and offending food. In all five individuals, food ingestion resulted in a significant rise of
lactulose:
mannitol urinary ratio and previous administration of
ketotifen resulted in a normalization of the
mannitol:
lactulose urinary ratio. Patients with
urticaria and/or angiooedema, gastrointestinal symptoms,
asthma, and oropharynx
pruritus with oedema of the lips were completely protected. In patients with
AD, 70% were greatly improved or improved but 30% remained the same. It is our impression that
ketotifen offers a new therapeutic dimension and
therapy in FA.