Reducing the Frequency of Ongoing Peanut Oral Immunotherapy in Children

Peanut allergy
Peanut allergy
How does a short-term halt in peanut oral immunotherapy or a reduced dosing frequency affect children who have already received a year of peanut OIT?

The following article is a part of conference coverage from the American Academy of Allergy, Asthma & Immunology Annual Meeting, being held in Phoenix, Arizona, from February 25 to 28, 2022. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the AAAAI 2022 Virtual Annual Meeting.

Reducing the frequency of maintenance dosing of peanut oral immunotherapy (OIT) in children after 1 year of therapy did not reduce sustained unresponsiveness in children studied. This was among the study findings presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting, held in Phoenix, Arizona, February 25 to 28.

This clinical trial of peanut-allergic children who had undergone 12 months of peanut OIT was designed to evaluate sustained unresponsiveness (SU) levels and symptom thresholds in children who had halted OIT for 4 weeks. Participants were recruited from the Boiled Peanut Oral Immunotherapy study ( Identifier: NCT02149719) of 47 children, (aged 8 to 17 years, 43% female) 18 of whom showed a peanut protein tolerance equal to or greater than 1.44 grams at 12 months of OIT. For these 18 participants, regular dosing was then stopped for 4 weeks, SU reassessed, unchanged. Then, regular dosing continued at a reduced frequency (3-5 times per week) for an additional 12 to 24 months for these 18 participants. An additional 8 children showed the 4-week SU unchanged at 24-36 months of OIT.

After the additional 12 months of reduced frequency dosing, the children’s 4-week SU was again assessed, and researchers found no change in the peanut dose triggering subjective or objective symptoms.

Researchers concluded that, “Despite a reduction in frequency of maintenance dosing after 1 year, there was no reduction in clinical efficacy.” Researchers suggested that patients and their families may prefer the less frequent dosing after 1 year of OIT as long as it does not compromise efficacy.


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Turner P, Darbar R, Shamji M, Campbell D, Patel N. Longer duration of peanut oral immunotherapy at a reduced dosing frequency increases the rate of sustained unresponsiveness without reducing clinical efficacy. Presented at: American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting; February 25–28, 2022; Phoenix, AZ. Abstract 421.