Median tolerated dose increased from 30 mg to 3,000 mg of peanut protein at the exit challenge, equivalent to 12 peanuts
By Elana Gotkine HealthDay Reporter
THURSDAY, May 1, 2025 (HealthDay News) — Peanut oral immunotherapy (OIT) is efficacious for adults with peanut allergy, according to a study published online April 23 in Allergy.
Hannah Hunter, from Guy’s and St. Thomas’ NHS Foundation Trust in London, and colleagues conducted a phase 2 trial to examine peanut OIT in peanut-allergic adults using real-world peanut products. Participants underwent baseline double-blind placebo-controlled food challenges (DBPCFC) with 0.3- to 300-mg doses of peanut protein. Participants who reacted were initiated on daily OIT with two-weekly updosing until a maintenance dose of 1,000 mg (four large peanuts) was reached. The proportion of OIT participants who tolerated a cumulative dose of 1.4 g peanut protein during exit DBPCFC was examined as the primary outcome.
The OIT group included 21 adults, with 67 percent achieving the daily maintenance dose and meeting the primary end point. The researchers found that three adults withdrew due to adverse reactions and three did not complete the trial for unrelated reasons. There was an increase in the median tolerated dose, from 30 mg to 3,000 mg at the exit challenge (about 1/8th to 12 peanuts). Improvement in quality-of-life measures was seen in association with OIT. In OIT, but not control participants, suppression of peanut skin-prick test sizes and induction of peanut-specific immunoglobulin G were observed.
“Peanut OIT can be an efficacious treatment for desensitization of adult peanut allergic patients,” the authors write.
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