High-Dose Peanut Oral Immunotherapy Safe, Effective for Peanut Allergy

salted peanuts, food allergy, epinephrine
High-dose peanut oral immunotherapy provided similar or greater efficacy than other previously reported forms of peanut oral immunotherapy without additional safety concerns.

This article is part of Pulmonology Advisor‘s coverage of the ACAAI 2019 meeting, taking place in Houston, TX. Our staff will report on medical research related to allergies, asthma, and more conducted by experts in the field. Check back regularly for more news from ACAAI 2019.


HOUSTON — High-dose peanut oral immunotherapy provided similar or greater efficacy than other previously reported forms of peanut oral immunotherapy without additional safety concerns, according to research presented at the American College of Allergy, Asthma, & Immunology Annual Scientific Meeting, held November 7 to 11, in Houston, Texas.

Researchers conducted a retrospective chart review of 244 patients (aged 18 months to 36 years; mean age, 9 years) who underwent peanut oral immunotherapy from July 2016 to July 2019. High dose was defined as 4 g or 8 g whole peanut (1.2 g or 2.4 g peanut protein, respectively). Patients were offered a triple-dose oral food challenge if they completed ≥6 months of maintenance peanut oral immunotherapy.

A total of 205 patients completed the up-dosing and are maintaining daily dosing of peanut oral immunotherapy, 22 patients are currently up-dosing, and 17 patients have discontinued therapy. The majority of patients (92.34%) reached their target dose. Of all patients, 60 underwent a triple-dose oral food challenge; 98.3% tolerated either 12 g or 24 g whole peanut (3.6 g or 7.2 g peanut protein, respectively).

With regard to safety, a total of 27 patients required epinephrine and the rate of epinephrine use per daily dose was 0.02%.

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The researchers stated that they encourage using peanut oral immunotherapy in an allergy clinic setting as it appears both safe and effective for the treatment of peanut allergy.

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Reference

Nguyen K, Carr W. High dose peanut oral immunotherapy in clinical practice is safe and effective. Presented at: American College of Allergy, Asthma, & Immunology 2019 Annual Scientific Meeting; November 7-11, 2019; Houston, Texas. Abstract P321.