For young children with peanut allergy, initiation of peanut oral immunotherapy increased desensitization and remission, according to a study published in The Lancet. Stacie M. Jones, MD, and colleagues conducted a randomized trial of children aged 12 to younger than 48 months who reacted to 500 mg or less of peanut protein during a double-blind, placebo-controlled food challenge (DBPCFC). Participants were randomly assigned to peanut oil immunotherapy or placebo (96 and 50 children, respectively) for 134 weeks, followed by 26 weeks of avoidance. The researchers found that 71% and 2% of those who received immunotherapy and placebo, respectively, achieved desensitization at week 134. During the week 134 DBPCFC, the median cumulative tolerated dose was 5,005 mg for immunotherapy and 5 mg for placebo. After avoidance, 21% and 2% of participants receiving immunotherapy and placebo, respectively, met remission criteria. During week 160, the median cumulative tolerated doses were 755 mg and 0 mg for immunotherapy and placebo, respectively. Younger age and lower baseline peanut-specific immunoglobulin E predicted remission in a multivariable regression analysis.
