Can Parent-Administered Low-Dose Peanut OIT Treat Allergy?

Medscape

a day ago

TOPLINE:
A low-dose peanut oral immunotherapy (OIT) protocol using parent-measured dosing can desensitize children aged 1-4 years with peanut allergy. The approach appears to be acceptably safe and may yield greater improvements in quality of life than peanut avoidance, researchers reported.
METHODOLOGY:
Investigators conducted a randomized trial that included 54 children with confirmed or highly probable peanut allergy at a tertiary pediatric hospital in Western Australia to compare peanut OIT with peanut avoidance.
Participants in the peanut OIT group received 1-360 mg of peanut protein in the form of defatted peanut flour sold as powdered peanut butter.
At 12 months, researchers assessed how many participants in the OIT and avoidance groups could tolerate > 600 mg peanut protein during an oral food challenge, the study's primary outcome.
Children's quality of life and parental burden were also assessed using questionnaires at weeks 12 and 24 and at the end of the study.
TAKEAWAY:
Overall, 74% of participants in the peanut OIT group vs 11% in the avoidance group achieved the primary outcome (odds ratio, 22.9; P < .001).
On the quality-of-life questionnaires, the peanut OIT group had significantly lower scores (indicating better quality of life) across domains like emotional impact, food-related anxiety, and social and dietary limitations.
A total of 79 treatment-related adverse events were reported for 21 participants in the peanut OIT group, with a median of two events per participant.
Three of the adverse events that occurred at home were treated with adrenaline.
Most treatment-related adverse events were grade 1 or 2, 11% were grade 3, and one was grade 4.
IN PRACTICE:
'A pragmatic protocol for pOIT [peanut OIT] relying on parent-measured doses of a commercially available food product is feasible, acceptable to parents, and results in similarly low rates of adverse events as other reported trials of pOIT in this age group,' the authors of the study wrote.
SOURCE:
Michael O'Sullivan, MBBS, with the University of Western Australia, Perth, Australia, was the corresponding author of the study, which was published online on August 4 in Clinical & Experimental Allergy.
LIMITATIONS:
This study had an open-label design and no placebo control. In other contexts, families may be less willing or able to adhere to an OIT regimen, the researchers noted.
DISCLOSURES:
This study was supported by the Department of Health, Government of Western Australia. O'Sullivan is a board director and the current president of the Australasian Society of Clinical Immunology and Allergy.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.