Peanut Immunotherapy for Patients Who Can Tolerate “A Little Bit of Peanut”

Peanut allergy affects ≈2% of people in the U.S. Some patients have allergic reactions to tiny amounts of peanut protein (<100 µg), but others have higher thresholds and can tolerate one half of a peanut (100 mg of peanut protein) or more. Researchers examined a peanut-desensitization protocol using store-bought peanut butter in these patients with higher thresholds.

Seventy-three children (age range, 4–14 years) who were allergic to peanut butter but could tolerate at least 143 mg of peanut protein were randomized to a peanut butter protocol or peanut avoidance. Patients started with about one eighth of a teaspoon of peanut butter daily (137 mg of peanut protein) and increased the dose every 8 weeks for 18 months until they reached a daily …