NIH

Introducing peanut in infancy prevents peanut allergy into adolescence

May 30, 2024

New research from the LEAP-Trio study finds that peanut consumption, starting in infancy and continuing to age 5 years, provides lasting tolerance to peanut into adolescence irrespective of subsequent peanut consumption, demonstrating that long-term prevention and tolerance can be achieved in food allergy.

“Today’s findings should reinforce parents’ and caregivers’ confidence that feeding their young children peanut products beginning in infancy according to established guidelines can provide lasting protection from peanut allergy,” said National Institute of Allergy and Infectious Diseases Director Jeanne Marrazzo, M.D., M.P.H. “If widely implemented, this safe, simple strategy could prevent tens of thousands of cases of peanut allergy among the 3.6 million children born in the United States each year.”

The LEAP-Trio study builds on the seminal results of the Learning Early About Peanut Allergy (LEAP) clinical trial and the subsequent LEAP-On study. The LEAP randomized trial demonstrated consumption of peanut from infancy to age 5 years prevented the development of peanut allergy. An extension of that trial—the LEAP-On study—demonstrated the effect persisted after 1 year of peanut avoidance.

The LEAP-Trio follow-up trial examined the durability of peanut tolerance at age 144 months after years of ad libitum peanut consumption.

LEAP-Trio study results

• The LEAP-Trio study enrolled 508 of the original 640 participants (79.4%); 497 had complete primary end point data.
• At age 144 months, peanut allergy remained significantly more prevalent in participants in the original peanut avoidance group than in the original peanut consumption group (15.4% [38 of 246 participants] vs. 4.4% [11 of 251 participants]; P<0.001).
• Participants in both groups reported avoiding peanuts for prolonged periods of time between 72 and 144 months.
• Participants at 144 months in the peanut consumption group had levels of Ara h2-specific immunoglobulin E (a peanut allergen associated with anaphylaxis) of 0.03 ± 3.42 kU/l and levels of peanut-specific immunoglobulin G4 of 535.5 ± 4.98 μg/l, whereas participants in the peanut avoidance group had levels of Ara h2-specific immunoglobulin E of 0.06 ± 11.21 kU/l and levels of peanut-specific immunoglobulin G4 of 209.3 ± 3.84 μg/l.
• Adverse events were uncommon, and the majority were related to the food challenge.

Sources:

Du Toit G, et al. (2024, June 3). NEJM Evid. Follow-up to Adolescence after Early Peanut Introduction for Allergy Prevention. https://pubmed.ncbi.nlm.nih.gov/38804779/

(2024, May 28). National Institutes of Health (NIH). News Releases. Introducing peanut in infancy prevents peanut allergy into adolescence. https://www.nih.gov/news-events/news-releases/introducing-peanut-infancy-prevents-peanut-allergy-into-adolescence