Peanut Oral Immunotherapy at Younger Age Ups Desensitization in Children

FRIDAY, Jan. 21, 2022 (HealthDay News) -- For young children with peanut allergy, initiation of peanut oral immunotherapy is associated with an increase in desensitization and remission, according to a study published in the Jan. 22 issue of The Lancet.

Stacie M. Jones, M.D., from the University of Arkansas for Medical Sciences in Little Rock, and colleagues conducted a randomized trial involving children aged 12 to younger than 48 months who were reactive to 500 mg or less of peanut protein during a double-blind, placebo-controlled food challenge (DBPCFC). Participants were randomly assigned to receive peanut oil immunotherapy (2,000 mg peanut protein/day) or placebo (96 and 50 children, respectively) for 134 weeks, followed by 26 weeks of avoidance.

The researchers found that 71 and 2 percent of those who received peanut oral immunotherapy and placebo, respectively, met the primary outcome of desensitization at week 134 (risk difference, 69 percent). During the week 134 DBPCFC, the median cumulative tolerated dose was 5,005 mg for peanut oral immunotherapy and 5 mg for placebo. After avoidance, 21 and 2 percent of participants receiving peanut oral immunotherapy and placebo, respectively, met remission criteria (risk difference, 19 percent). During week 160, the median cumulative tolerated dose was 755 mg and 0 mg for peanut oral immunotherapy and placebo, respectively. Younger age and lower baseline peanut-specific immunoglobulin E were predictive of remission in a multivariable regression analysis.

"Peanut oral immunotherapy resulted in desensitization in most children and remission in a substantial proportion of children compared with placebo," the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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