NIH

Home dosing protocol helps peanut-allergic kids tolerate tablespoons of peanut butter

February 21, 2025

Eating gradually increasing doses of store-bought, home-measured peanut butter for about 18 months enabled 100% of children with peanut allergy who initially could tolerate at least half a peanut to consume three tablespoons of peanut butter without an allergic reaction. This approach could help about half of children with peanut allergy, who can already tolerate at least half a peanut. The trial, funded by the NIH’s National Institute of Allergy and Infectious Diseases and published in NEJM Evidence, involved 73 children aged 4 to 14 years.

Children in the peanut-ingestion group started with 1/8 teaspoon of peanut butter daily, gradually increasing their dose every 8 weeks up to 1 tablespoon. None needed epinephrine for severe reactions during home dosing, and only one needed it during supervised dosing. After treatment, all 32 children in the peanut-ingestion group could tolerate 9 grams of peanut protein (3 tablespoons of peanut butter) in an oral food challenge, compared with only three of 30 children in the avoidance group.

During the COVID-19 pandemic, some children didn't return for the oral food challenge. Using statistical techniques, 100% of the ingestion group and 21% of the avoidance group tolerated at least 2 doses greater than at the outset. After 16 weeks of consuming at least 2 tablespoons of peanut butter weekly, followed by 8 weeks of avoidance, 86.7% of the treated children continued to tolerate 9 grams of peanut protein.

Source:

NIH. (2025, February 10). Therapy helps peanut-allergic kids tolerate tablespoons of peanut butter. https://www.nih.gov/news-events/news-releases/therapy-helps-peanut-allergic-kids-tolerate-tablespoons-peanut-butter