Efficacy of oral immunotherapy in children with peanut allergy

A new study in the United States shows that oral immunotherapy with peanuts can help children get rid of peanut allergies or achieve remission criteria. Furthermore, the younger the age, the younger the initiation of treatment, the higher the remission rate.

What is a peanut allergy?

Peanut.

Peanuts, also known as peanuts, are one of the most common causes of severe allergic reactions. For some people with a peanut allergy, even small amounts of peanuts can cause a serious, possibly life-threatening reaction (anaphylaxis).

A peanut allergy occurs when the immune system mistakenly believes that the protein in peanuts is something harmful. Direct or indirect exposure to peanuts causes the immune system to release symptoms-causing chemicals into the bloodstream.

These types of exposure are:

1. Direct contact: Eating peanuts or peanut-containing foods, even skin-to-skin contact with peanuts. 
2. Indirect exposure: Exposure to peanuts due to unintended inclusion in a product. For example, during processing or handling that causes food to come into contact with peanuts.
3. Inhalation: Inhalation of peanut powder, cooking peanut oil…

Efficacy and safety of peanut oral immunotherapy in children (IMPACT)

Study on the efficacy and safety of peanut oral immunotherapy in children.

According to research, about 2% of children in the United States (nearly 1.5 million) are allergic to peanuts. These children are at high risk for life-threatening allergic reactions, most of whom have lifelong peanut allergies.

For young children with peanut allergies, diet is the current standard of care.

The researchers believe that because oral immunotherapy has the potential to alter the immune system, while the immune system is still in the process of maturing, the delivery of pea-based oral immunotherapy may be appropriate. Peanuts can change a child's immune response to peanuts. 

Two earlier studies provided a proof of concept that oral peanut immunotherapy could be used safely and therapeutically in very young children.

The IMPACT clinical trial, funded by the National Institutes of Health (NIH), enrolled 146 infants and toddlers 1 to 3 years of age with peanut allergy at five US academic medical centers. Ky. These 146 children were randomly assigned, including, 96 children were given peanut protein powder daily, the dose was gradually increased to 2 grams (equivalent to about 6 peanuts), the remaining 50 children were in the control group. placebo, was eating oatmeal. The duration of treatment is 2 and a half years.

The results showed that 71% of the children receiving this therapy achieved desensitization and were able to receive the equivalent of 16 peanuts, compared with only 2% of the children in the placebo group. 21% of the children receiving the therapy met the remission criteria, tolerating doses of about 6 to 12 peanuts, compared with only 2% of the children in the placebo group.

The researchers also found that the younger the children who were allergic to peanuts, the higher their remission rates were if they started the trial at an early age. The data show that the rate of achieving remission in children starting treatment at 1 year of age is 71%, from 2 years old is 35% and from 3 years old is 19%.

Study co-author Stacie Jones said: 'Very early intervention may provide the best time to achieve remission.'

Nearly all children receiving this therapy experience at least one reaction during treatment, but most reactions are mild to moderate. The study, conducted under strict medical supervision, found that 21 children who needed to be treated with epinephrine for 35 moderate reactions to peanut powder during treatment lasted 2 and a half years.

The trial results were published on January 22 in the international medical journal The Lancet.