Imperial College London

Dr Robert Boyle

Faculty of MedicineNational Heart & Lung Institute

Reader in Paediatric Allergy
 
 
 
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Contact

 

+44 (0)20 3312 7892r.boyle Website

 
 
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Location

 

Paediatric Research UnitQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

308 results found

Allen H, Boyle RJ, 2022, Dietary management of breastfed children with food allergy., Clin Exp Allergy, Vol: 52, Pages: 29-32

Journal article

Boyle RJ, Shamji MH, 2022, Milk allergy over-diagnosis., Clin Exp Allergy, Vol: 52, Pages: 4-6

Journal article

Van Vogt E, Cro S, Cornelius VR, Williams HC, Askie LM, Phillips R, Kelleher MM, Boyle RJet al., 2021, Individual Participant Data Meta-Analysis versus Aggregate Data Meta-Analysis: a case study in eczema and food allergy prevention., Clin Exp Allergy

INTRODUCTION: Meta-analysis traditionally uses aggregate data from published reports. Individual Participant Data (IPD) meta-analysis, which obtains and synthesises participant-level data, is potentially more informative, but resource-intensive. The impact on the findings of meta-analyses using IPD in comparison to aggregate data has rarely been formally evaluated. METHODS: We conducted a secondary analysis of a Cochrane systematic review of skin care interventions for preventing eczema and food allergy in infants to identify the impact of the analytical choice on the review's findings. We used aggregate data meta-analysis only and contrasted the results against those of the originally published IPD meta-analysis. All meta-analysis used random effects inverse variance models. Certainty of evidence was evaluated using GRADE. RESULTS: The pooled treatment effects for the Cochrane systematic review's co-primary outcomes of eczema and food allergy were similar in IPD meta-analysis (eczema RR 1.03, 95% CI 0.81, 1.31; I2 41%, 7 studies 3075 participants), and aggregate meta-analysis (eczema RR 1.01 95% CI 0.77, 1.33; I2 53%, 7 studies, 3089 participants). In aggregate meta-analysis the statistical heterogeneity could not be explained but using IPD it was explained by one trial which used a different, bathing intervention. For IPD meta-analysis, risk of bias was assessed as lower and more adverse event data were available compared with aggregate meta-analysis. This resulted in higher certainty of evidence, especially for adverse events. IPD meta-analysis enabled analysis of treatment interactions by age and hereditary eczema risk; and analysis of the effect of treatment adherence using pooled complier-adjusted-causal-effect analysis, none of which was possible in aggregate meta-analysis. CONCLUSIONS: For this systematic review, IPD did not significantly change primary outcome risk ratios compared with aggregate data meta-analysis. However, certainty of evidence, safety out

Journal article

Smith TDH, Townsend R, Hussain HS, Santer M, Boyle RJet al., 2021, Milk allergy guidelines for infants in England promote over-diagnosis: A cross-sectional survey, CLINICAL AND EXPERIMENTAL ALLERGY, ISSN: 0954-7894

Journal article

Mehta S, Allen HI, Simpson MR, Campbell DE, Arntsen KF, Boyle RJet al., 2021, Patterns of specialised formula consumption in Australia, England and Norway suggest significant milk allergy over-diagnosis, Publisher: WILEY, Pages: 1661-1661, ISSN: 0954-7894

Conference paper

Shamji MH, Boyle RJ, 2021, Allergic diseases and novel targets in allergen immunotherapy, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 1526-1528, ISSN: 0954-7894

Journal article

Pendower UM, Allen HI, Boyle RJ, 2021, A Delphi consensus project to guide the safe detection and management of cow's milk allergy in infants and children, Publisher: WILEY, Pages: 1689-1689, ISSN: 0954-7894

Conference paper

Shamji MH, Boyle RJ, Fox AT, 2021, Prize-winning abstracts from BSACI 2021 meeting, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 1529-1530, ISSN: 0954-7894

Journal article

Boyle RJ, Shamji MH, 2021, Developments in the field of allergy in 2020 through the eyes of Clinical and Experimental Allergy, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 1531-1537, ISSN: 0954-7894

Journal article

Singleton H, Hodder A, Boyers D, Doney L, Almilaji O, Heaslip V, Thompson AR, Boyle RJ, Axon E, Van Onselen J, O'Meara S, Roberts A, Ersser SJet al., 2021, Psychological and educational interventions for managing eczema, Cochrane Database of Systematic Reviews, Vol: 2021, ISSN: 1465-1858

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. 1. To assess the clinical outcomes of psychological and educational interventions in children and adults with eczema. 2. To summarise the availability and principal findings of relevant economic evaluations.

Journal article

Genuneit J, Jayasinghe S, Riggioni C, Peters RL, Chu DK, Munblit D, Boyle RJ, Du Toit G, Skypala I, Santos AFet al., 2021, Protocol for a systematic review of the diagnostic test accuracy of tests for IgE-mediated food allergy, PEDIATRIC ALLERGY AND IMMUNOLOGY, ISSN: 0905-6157

Journal article

Szeto MD, Hassan S, Hamp A, Anderson J, Sivesind TE, Anderson JB, Laughter MR, Makrygeorgou A, Boyle RJ, Dellavalle RPet al., 2021, From the Cochrane Library: Probiotics for treating eczema., J Am Acad Dermatol

Journal article

Boyle RJ, Shamji MH, 2021, Making causal inferences in allergy epidemiology studies, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 1404-1406, ISSN: 0954-7894

Journal article

Patel N, Chong KW, Yip AYG, Ierodiakonou D, Bartra J, Boyle RJ, Turner PJet al., 2021, Use of multiple epinephrine doses in anaphylaxis: A systematic review and meta-analysis, Journal of Allergy and Clinical Immunology, Vol: 148, Pages: 1307-1315, ISSN: 0091-6749

Background:Regulatory bodies recommend that all patients at risk of anaphylaxis be prescribed 2 epinephrine autoinjectors, which they should carry at all times. This is in contrast to some guidelines. The proportion of anaphylaxis reactions that are treated with multiple doses of epinephrine has not been systematically evaluated.Objective:Our aim was to undertake a systematic review and meta-analysis of published studies reporting epinephrine treatment for anaphylaxis in which data relating to the number of doses administered were available.Methods:We searched the Medline, Embase, and Cochrane databases for relevant studies reporting at least 10 anaphylaxis events (due to food or venom) from 1946 until January 2020. Data were extracted in duplicate for the meta-analysis, and the risk of bias was assessed. The study was registered under the PROSPERO identifier CRD42017069109.Results:A total of 86 studies (36,557 anaphylaxis events) met the inclusion criteria (20 of the studies [23%] were prospective studies; 64 [74%] reported reactions in the community, and 22 [26%] included food challenge data). Risk of bias was assessed as low in 50 studies. Overall, 7.7% of anaphylaxis events from any cause (95% CI = 6.4-9.1) were treated with multiple doses of epinephrine. When only epinephrine-treated reactions for which subsequent doses were administered by a health care professional were considered, 11.1% of food-induced reactions (95% CI = 9.4-13.2) and 17.1% of venom-induced reactions (95% CI = 11.3-25.0) were treated with at least 1 epinephrine dose. Heterogeneity was moderate to high in the meta-analyses, but at sensitivity analysis it was not affected by study design or anaphylaxis definition.Conclusion:Around 1 in 10 anaphylaxis reactions are treated with at least 1 dose of epinephrine.

Journal article

Musters AH, Mashayekhi S, Harvey J, Axon E, Lax SJ, Flohr C, Drucker AM, Gerbens L, Ferguson J, Ibbotson S, Dawe RS, Garritsen F, Brouwer M, Limpens J, Prescott LE, Boyle RJ, Spuls PIet al., 2021, Phototherapy for atopic eczema., Cochrane Database Syst Rev, Vol: 10

BACKGROUND: Atopic eczema (AE), also known as atopic dermatitis, is a chronic inflammatory skin condition that causes significant burden. Phototherapy is sometimes used to treat AE when topical treatments, such as corticosteroids, are insufficient or poorly tolerated. OBJECTIVES: To assess the effects of phototherapy for treating AE. SEARCH METHODS: We searched the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, and ClinicalTrials.gov to January 2021. SELECTION CRITERIA: We included randomised controlled trials in adults or children with any subtype or severity of clinically diagnosed AE. Eligible comparisons were any type of phototherapy versus other forms of phototherapy or any other treatment, including placebo or no treatment. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodology. For key findings, we used RoB 2.0 to assess bias, and GRADE to assess certainty of the evidence. Primary outcomes were physician-assessed signs and patient-reported symptoms. Secondary outcomes were Investigator Global Assessment (IGA), health-related quality of life (HRQoL), safety (measured as withdrawals due to adverse events), and long-term control. MAIN RESULTS: We included 32 trials with 1219 randomised participants, aged 5 to 83 years (mean: 28 years), with an equal number of males and females. Participants were recruited mainly from secondary care dermatology clinics, and study duration was, on average, 13 weeks (range: 10 days to one year). We assessed risk of bias for all key outcomes as having some concerns or high risk, due to missing data, inappropriate analysis, or insufficient information to assess selective reporting. Assessed interventions included: narrowband ultraviolet B (NB-UVB; 13 trials), ultraviolet A1 (UVA1; 6 trials), broadband ultraviolet B (BB-UVB; 5 trials), ultraviolet AB (UVAB; 2 trials), psoralen plus ultraviolet A (PUVA; 2 trials), ultraviolet A (UVA; 1 trial), unspecified ultraviolet B (UVB; 1 trial), full spectrum ligh

Journal article

Helfer B, Leonardi-Bee J, Mundell A, Parr C, Ierodiakonou D, Garcia-Larsen V, Kroeger CM, Dai Z, Man A, Jobson J, Dewji F, Kunc M, Bero L, Boyle Ret al., 2021, Conduct and reporting of formula milk trials: systematic review, BMJ: British Medical Journal, Vol: 375, Pages: 1-9, ISSN: 0959-535X

Objective To systematically review the conduct and reporting of formula trials.Design Systematic review.Data sources Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 1 January 2006 to 31 December 2020.Review methods Intervention trials comparing at least two formula products in children less than three years of age were included, but not trials of human breast milk or fortifiers of breast milk. Data were extracted in duplicate and primary outcome data were synthesised for meta-analysis with a random effects model weighted by the inverse variance method. Risk of bias was evaluated with Cochrane risk of bias version 2.0, and risk of undermining breastfeeding was evaluated according to published consensus guidance. Primary outcomes of the trials included in the systematic review were identified from clinical trial registries, protocols, or trial publications.Results 22 201 titles were screened and 307 trials were identified that were published between 2006 and 2020, of which 73 (24%) trials in 13 197 children were prospectively registered. Another 111 unpublished but registered trials in 17 411 children were identified. Detailed analysis was undertaken for 125 trials (23 757 children) published since 2015. Seventeen (14%) of these recently published trials were conducted independently of formula companies, 26 (21%) were prospectively registered with a clear aim and primary outcome, and authors or sponsors shared prospective protocols for 11 (9%) trials. Risk of bias was low in five (4%) and high in 100 (80%) recently published trials, mainly because of inappropriate exclusions from analysis and selective reporting. For 68 recently published superiority trials, a pooled standardised mean difference of 0.51 (range −0.43 to 3.29) was calculated with an asymmetrical funnel plot (Egger’s test P<0.001), which reduced to 0.19 after correction for asymmetry. Primary outcomes were reporte

Journal article

Turner P, Durham S, Skypala I, Boyle RBet al., 2021, No apparent impact of incremental dosing on eliciting dose at double-blind, placebo-controlled peanut challenge, Allergy, Pages: 1-3, ISSN: 0105-4538

Journal article

Boyle RJ, Shamji MH, 2021, Allergy societies and the formula industry, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 1260-1261, ISSN: 0954-7894

Journal article

Shamji MH, Boyle RJ, 2021, Unmet needs in food allergy, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 1258-1259, ISSN: 0954-7894

Journal article

Boyle RJ, Shamji MH, 2021, Asthma management and impact on COVID-19 outcomes, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 1100-1102, ISSN: 0954-7894

Journal article

Shamji MH, Boyle RJ, 2021, Biomarkers in asthma and allergic diseases, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 982-984, ISSN: 0954-7894

Journal article

Boyle RJ, Shamji MH, 2021, Evidence Synthesis in Allergy - A call for submissions, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 868-869, ISSN: 0954-7894

Journal article

Shamji MH, Boyle RJ, 2021, Real word evidence studies: Is it the way forward?, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 748-750, ISSN: 0954-7894

Journal article

Argiz L, Infante S, Machinena A, Bracamonte T, Echeverria L, Prieto A, Garriga T, Vila L, Gonzalez-Delgado P, Garcia-Magan C, Garcia E, Carballeira I, Vazquez-Cortes S, Mori F, Barni S, Arasi S, Pascal M, Boyle RJ, Vazquez-Ortiz Met al., 2021, Children with acute food protein-induced enterocolitis syndrome from Spain and Italy usually tolerate all other food groups, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 1238-1241, ISSN: 0954-7894

Journal article

Allan PJ, Ambrose T, Mountford C, Bond A, Donnellan C, Boyle R, Calvert C, Cernat E, Clarke E, Cooper SC, Donnelly S, Evans B, Glynn M, Hewett R, Holohan AS, Leitch EF, Louis-Auguste J, Mehta S, Naik S, Nightingale J, Rafferty G, Rodrigues A, Sharkey L, Small M, Teubner A, Urs A, Wyer N, Lal Set al., 2021, COVID-19 infection in patients with intestinal failure: UK experience, JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, Vol: 45, Pages: 1369-1375, ISSN: 0148-6071

Journal article

Genuneit J, Boyle RJ, 2021, Hydrolysed formula and allergy prevention, PEDIATRIC ALLERGY AND IMMUNOLOGY, Vol: 32, Pages: 667-669, ISSN: 0905-6157

Journal article

Turner P, Ruiz-Garcia M, Patel N, Abrantes G, Burrell S, Vazquez-Ortiz M, Skypala I, Durham S, Boyle Ret al., 2021, Delayed symptoms and orthostatic intolerance following peanut challenge, Clinical and Experimental Allergy, Vol: 51, Pages: 696-702, ISSN: 0954-7894

BackgroundClinical reactions to Oral Food Challenge (OFC) in peanut‐allergic individuals have been well‐characterised, but rates and phenotypes of symptom recurrence beyond the first hour after objective symptoms are less well‐characterised.ObjectiveTo evaluate the rate of new‐onset symptoms occurring at least 1 h after stopping OFC in peanut‐allergic children and adults undergoing peanut‐OFC.MethodsWe prospectively collected data relating to adverse events following positive reactions at double‐blind, placebo‐controlled food challenges (DBPCFC) to peanut in children and adults evaluated for eligibility to participate in two clinical trials (NCT02149719, NCT02665793). The trials included people aged 8 to 45 with primary, IgE‐mediated peanut allergy at DBPCFC. The challenge protocol included consumption of a light meal 1 h after reaction.ResultsA total of 121 participants (64 children, 57 adults) had immediate, objective symptoms at DBPCFC, 25 (17 children, 8 adults) with anaphylaxis. Thirty‐three (27%) had progression or recurrence of symptoms ≥ 1 h after objective clinical reaction, of whom 8 developed anaphylaxis. In 23 cases, the onset of new symptoms was associated with consumption of a light meal. In eight cases, symptoms were limited to a symptomatic postural fall in blood pressure noted in preparation for discharge, without any other new features of an allergic reaction.Conclusions & Clinical RelevanceProgressive or new‐onset symptoms ≥1 h following initial allergic reaction at OFC are common and can include orthostatic hypotension. Recurrent symptoms may be temporally associated with food consumption.

Journal article

Boyle RJ, Shamji MH, 2021, What does it mean to be food allergic?, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 634-635, ISSN: 0954-7894

Journal article

Shamji MH, Boyle RJ, 2021, New innovations in allergy treatment and phenotyping, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 514-517, ISSN: 0954-7894

Journal article

Bramer S, Boyle R, Weaver G, Shenker Net al., 2021, Use of donor human milk in nonhospitalized infants: An infant growth study, Maternal and Child Nutrition, Vol: 17, Pages: 1-9, ISSN: 1740-8695

When mother's own milk (MOM) is unavailable or insufficient, donor human milk (DHM) is recommended as the next best alternative for low birthweight infants. DHM use for healthy, term infants is increasing, but evidence for growth and tolerability is limited. This retrospective study evaluated growth in term infants in the community who received DHM from a UK milk bank. Mothers of infants receiving DHM between 2017 and 2019 were contacted (n = 49), and 31 (63.2%) agreed to participate. Fourteen infants received DHM as a supplement to other feeds (MOM and/or infant formula) and 17 were exclusively fed DHM where breastfeeding was impossible (range: 3–6 weeks). Growth was assessed by deriving z‐scores using the WHO standard for infant growth and compared with 200 exclusively breastfed infants. Multivariate regression analysis revealed no feeding method‐specific association between z‐score and age, nor between weight and age, suggesting that z‐scores and growth velocity were not affected by feeding exclusive MOM, supplemental DHM or exclusive DHM. DHM was well‐tolerated with no adverse events that led to early cessation. After receiving supplemental DHM group, 63% of infants whose mothers had no physical barrier to breastfeeding (5/8 infants) were exclusively breastfed. This novel study reports adequate growth outcomes of healthy nonhospitalized infants receiving DHM, either as the sole milk source or supplement. Prospective studies are needed to confirm whether DHM is a suitable feeding alternative for term infants in the community, optimal durations, as well as the impact of DHM availability on breastfeeding rates and maternal mental health.

Journal article

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