Diagnosis and rationale for action against Cow's milk allergy (DRACMA): A summary report

Alessandro Fiocchi, Holger J. Schünemann, Jan Brozek, Patrizia Restani, Kirsten Beyer, Riccardo Troncone, Alberto Martelli, Luigi Terracciano, Sami L. Bahna, Fabienne Rancé, Motohiro Ebisawa, Ralf G. Heine, Amal Assa'ad, Hugh Sampson, Elvira Verduci, G. R. Bouygue, Carlos Baena-Cagnani, Walter Canonica, Richard F. Lockey

Research output: Contribution to journalArticlepeer-review


The 2nd Milan Meeting on Adverse Reactions to Bovine Proteins was the venue for the presentation of the first consensus-based approach to the management of cow's milk allergy. It was also the first time that the Grading of Recommendations, Assessments, Development, and Evaluation approach for formulating guidelines and recommendations was applied to the field of food allergy. In this report we present the contributions in allergen science, epidemiology, natural history, evidence-based diagnosis, and therapy synthesized in the World Allergy Organization Diagnosis and Rationale for Action against Cow's Milk Allergy guidelines and presented during the meeting. A consensus emerged between discussants that cow's milk allergy management should reflect not only basic research but also a newer and better appraisal of the literature in the light of the values and preferences shared by patients and their caregivers in partnership. In the field of diagnosis, atopy patch testing and microarray technology have not yet evolved for use outside the research setting. With foreseeable breakthroughs (eg, immunotherapy and molecular diagnosis) in the offing, the step ahead in leadership can only stem from a worldwide organization implementing consensus-based clinical practice guidelines to diffuse and share clinical knowledge.

Original languageEnglish
JournalJournal of Allergy and Clinical Immunology
Issue number6
Publication statusPublished - Dec 2010


  • amino acid formula
  • Assessments
  • Cow's milk allergy
  • Development, and Evaluation approach
  • epidemiology
  • Grading of Recommendations
  • hydrolyzed milk formula
  • hydrolyzed rice formula
  • oral immunotherapy
  • skin prick test
  • soy formula
  • specific IgE

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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