Oral Immunotherapy Tested on Peanut Allergies
Children with peanut allergies can build up a tolerance by consuming increasing increments of peanut protein on a regular basis, according to a new study.
Approximately 100 children (between the ages of 7 and 16) were selected based on having an immediate hypersensitive reaction after peanut ingestion, positive skin prick test to peanuts, and positive by double-blind, placebo-controlled food challenge.
The participants were randomized to either avoid peanuts entirely or participate in 26 weeks of oral immunotherapy—daily doses of peanut flour were increased incrementally over time, up to 800 mg/day.
After 26 weeks, 62% (24 of 39 participants) in the oral immunotherapy group and none of the control group were desensitized, or tolerated daily ingestion of 800 mg protein or the equivalent of 5 peanuts.
After a second phase, 54% tolerated the 1400 mg challenge (equivalent to 10 peanuts) and 91% tolerated daily ingestion of 800 mg protein.
Side effects were mild in most participants, with gastrointestinal symptoms the most common (31 participants reported nausea, 31 with vomiting and 1 with diarrhea). Participants also reported oral itching and wheezing.
Researchers concluded that oral immunotherapy did successfully desensitize most children within the study population with peanut allergy of any severity. Further studies in wider populations are recommended and researchers stressed against conducting such studies in non-specialist settings.
Reference: Anagnostou K, Islam S, King Y, et al. Assessing the efficacy of oral immunotherapy for the desensitization of peanut allergy in children (STOP II): a phase 2 randomized controlled trial. Lancet. 2104 Jan 30. doi: 10.1016/S0140-6736(13)62301-6