Peanut Oral Immunotherapy Effective in Allergic Preschool Children

Forty peanut-allergic children aged 9–36 months were randomized to high- or low-dose OIT
Forty peanut-allergic children aged 9–36 months were randomized to high- or low-dose OIT

A study reported that close to 80% of peanut-allergic preschool children successfully integrated peanut-containing foods into their diets after treatment with peanut oral immunotherapy (OIT) with no allergic response. Findings from the study are published in the Journal of Allergy and Clinical Immunology

Peanut OIT consists of consuming small, and gradually increasing, the amount of peanut protein daily. The study authors found both low- and high doses of OIT were safe and equally effective at suppressing allergic immune responses to peanut. 

Earlier studies involving older children had shown that peanut OIT could offer some protection against anaphylaxis caused by peanut exposure. For the Determining the Efficacy and Value of Immunotherapy on the Likelihood of Peanut Tolerance (DEVIL) study, researchers from University of North Carolina Chapel Hill looked at whether administering OIT to younger children with a short duration of peanut allergy could change the course of the allergy and help safely incorporate peanut into the diet. 

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The study included 40 peanut-allergic children aged 9–36 months. They were randomized to either high-dose OIT (target dose 3,000mg peanut protein) or a low-dose OIT (target dose 300mg peanut protein). Almost all study patients experienced side effects (eg, abdominal pain), but they were generally mild. After an average OIT duration of 29 months, study patients completely avoided peanuts for 4 weeks prior to reintroducing it into their diets. 

Close to 80% of of study patients successfully reintroduced peanut with no allergic response, and with no significant differences between the low- vs. high-dose groups. In addition, OIT-treated children were 19 times more likely to successfully add peanut into their diets compared to the control group (n=154) of peanut-allergic children who had avoided peanuts. 

Study authors are continuing to monitor the OIT-treated patients for long-term treatment outcomes. The final data collection date for primary outcome measure is anticipated to be in January 2017. Another randomized trial, IMPACT, is evaluating whether peanut OIT can reduce the risk of allergic reactions, induce tolerance, and change the immune responses of peanut-allergic children aged 12–48 months.

For more information visit jacionline.org.

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