Oral Immunotherapy Desensitizes Youth with Peanut Allergy

By Kelly Young

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Oral immunotherapy effectively desensitized children and adolescents with severe peanut allergy, according to a phase 3, industry-conducted trial published in the New England Journal of Medicine and presented at the American College of Allergy, Asthma & Immunology's annual meeting.

Roughly 550 participants aged 4 to 55 years with peanut allergy were randomized to receive either daily placebo or peanut flour-derived AR101. Doses gradually increased to 300 mg. After 1 year, participants took an exit food challenge in which they ingested 600 mg of peanut protein, the equivalent of two peanut kernels.

Among those aged 4 to 17, roughly 67% of the treatment group could complete the challenge with no more than mild symptoms, compared with 4% of the placebo group. During treatment, severe reactions were more common in the active treatment group (4.3% vs. 0.8%). Side effects led to trial withdrawal of 12% of immunotherapy patients.

Among adults, the treatment effect was not statistically significant.

An editorialist notes that "sustained, potentially lifelong, regular consumption may be needed to maintain allergen tolerance."