Allergy

Is oral immunotherapy effective in adults with peanut allergy?

April 29, 2025

Peanut oral immunotherapy (OIT) appears to effective in adults with peanut allergy, significantly increasing the tolerated dose of peanut protein and improving quality of life.

Study details: Using real-world peanut products, this phase II trial evaluated the efficacy of peanut OIT in peanut-allergic adults. Participants underwent baseline double-blind placebo-controlled food challenges (DBPCFC) with peanut protein doses ranging from 0.3 to 300 mg. Those who reacted were initiated on daily OIT with bi-weekly updosing until reaching a maintenance dose of 1000 mg (equivalent to four large peanuts). Primary outcome was the proportion of participants who tolerated a cumulative dose of 1.4 g peanut protein during exit DBPCFC.

Results: Twenty-one adults were enrolled in the OIT group, with 67% achieving the daily maintenance dose and meeting the primary endpoint. Median tolerated dose increased from 30 mg (~1/8th of a peanut) to 3000 mg (12 peanuts) at the exit challenge, representing a 100-fold increase (p < 0.0001). Three participants withdrew due to adverse reactions, and three didn't complete the trial for reasons unrelated to OIT. Improvements in quality of life measures, suppression of peanut skin prick test sizes, and induction of peanut-specific IgG were observed in OIT participants.

Source:

Hunter H, et al. (2025, April 23). Allergy. Oral Immunotherapy in Peanut-Allergic Adults Using Real-World Materials. https://pubmed.ncbi.nlm.nih.gov/40268292/