The Safety of Peanut Oral Immunotherapy in Peanut-Allergic Subjects in a Single-Center Trial

Abstract

Background: Peanut allergy is the leading cause of food-related anaphylaxis, and accidental exposures are common. Oral immunotherapy (OIT) has been posited as a potential treatment. Methods: Patients aged 3–65 years with peanut-specific IgE ≥7 kU/l and/or a positive skin prick test with a history of an allergic reaction to peanut were recruited to undergo an OIT protocol. All adverse reactions were recorded by research staff or patients in real time. Results: Twenty-four patients received 6,662 doses. Symptoms were mostly mild (84%), and only 3 severe gastrointestinal reactions required the administration of epinephrine. Abdominal pain was the most common reaction, followed by oropharyngeal and lip pruritus. Respiratory symptoms were rare. Conclusions: In this trial of OIT in adults and children, most reactions were mild.

Searching for a Safe, Cheap and Simple Protocol to Desensitize Children with Peanut Allergy. Patient Data of Four Children with Peanut Allergy Undergoing Oral Immunotherapy (OIT)

“…We believe that this simple OIT procedure for peanut allergy by applying an individually tailored desensitization protocol with incremental dosage of crushed peanut powder can be securely carried out for most of the patients. Similar results with a high security profile could also be shown by Yu et al [9]. However, for patients with the history of life-threatening anaphylactic reactions after peanut ingestion or getting these reactions during challenge tests , lower starting doses like 0.05-0.1 mg or less [3] are probably needed to minimize risks for these most sensitive patients.…”

Oral immunotherapy for the treatment of food allergy

“…9,11,22,23,31,[36][37][38][39] This is probably due to differences in escalation protocols, allergens, selection of participants and use of prophylactic medication. Most reported symptoms tend to be local pruritus or abdominal pain which are mostly mild and can generally be controlled with anti-histamine prophylaxis or anti-leukotriene medication.…”

Immunotherapy in allergy and cellular tests

“…127 Concern about peanut allergy rises up to some years ago 131,132 but many AIT approaches are quite recent. 115,133 Well designed, prospective clinical trials are urgently needed to determine whether OIT is a safe, effective form of therapy for food allergy. 120,121,134,135 In food allergy, immunotherapy is usually performed by oral or sublingual administration of allergens: several research studies have assessed that oral and sublingual immunotherapy for food allergy is generally well-tolerated and safe in highly controlled clinical settings.…”