Peanut Oral Immunotherapy Effective for Children Under 12 Months

MONDAY, Aug. 14, 2023 (HealthDay News) -- Peanut oral immunotherapy (OIT) can induce desensitization to peanuts in children younger than 12 months of age, according to research published online July 13 in the Journal of Allergy and Clinical Immunology: In Practice.

Sarah Johnson, M.D., from the Cleveland Clinic Foundation, and colleagues reviewed the safety and effectiveness of peanut OIT in 22 children younger than 12 months of age in a retrospective study. Participants were typically started at 18 mg of peanut protein, and doses were escalated every two weeks until reaching a maintenance dose of 500 mg or more.

The researchers found that maintenance was achieved in 100 percent of patients. Overall, 13, eight, and four patients reacted during in-office up-doses, at-home during the build-up phase, and at-home during the maintenance phase, respectively. One child required epinephrine; reactions self-resolved in most children. Six patients (27 percent) had no reaction. One patient discontinued OIT after reaching maintenance due to family preference. Fourteen patients qualified for and participated in specific immunoglobulin E (sIgE) testing after maintenance for six months; all had a peanut sIgE of ≤2 kU/L. Of these 14 participants who were then offered peanut oral food challenge (OFC), 11 participated in OFC and 10 had a negative OFC.

"Overall, this signals that age is a crucial factor to the success of this treatment," Johnson said in a statement. "An infant's immune system is more adaptable, allowing them to develop tolerance to peanuts with less severe reactions and fewer side effects than older children."

One author disclosed consulting work for Genentech.

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