80% of Peanut Allergic Children Can Suppress Allergy After OIT Treatment, Study Finds

11 Aug 2016 --- A new clinical study from the University of North Carolina at Chapel Hill has found that peanut oral immunotherapy (OIT) could be effective in treating peanut allergies in very young children. Eighty percent of peanut-allergic preschool children successfully incorporated peanut-containing foods into their diets after receiving the OIT treatment.

The new research follows previous studies on older children that showed that peanut OIT can offer some protection against potentially life-threatening anaphylaxis caused by peanut exposure.

Peanut oral immunotherapy (OIT) involves eating small, gradually increasing amounts of peanut protein daily.

The study assessed whether giving OIT to younger children whose duration of peanut allergy was short could alter the course of the allergy and allow safe introduction of peanut into the diet.

Researchers enrolled 40 peanut-allergic children aged between 9 to 36 months. They randomly assigned participants to either high-dose peanut OIT with a target daily dose of 3,000 milligrams peanut protein, or a low-dose regimen with a target dose of 300 milligrams.

Marshall Plaut, M.D., of the National Institute of Allergy and Infectious Diseases (NIAID), told NutritionInsight: “Younger children have a more responsive immune system, which can respond to immunotherapy by controlling peanut allergy, and this success in younger children is so impressive that it is important to focus on the success.” 

He continued, adding, “It is important to (a) understand why therapy is so successful in younger children and (b) use the understanding of this success to apply the information to improve the success of therapy in older children and adults.”

Nearly all participants experienced some side effects, such as abdominal pain, but these were generally mild, and required little or no treatment. After receiving OIT for 29 months on average, participants avoided peanut completely for four weeks before attempting to reintroduce it into their diets.

Results revealed that just under 80% of participants who successfully reintroduced peanut into their diet showed no allergic response, with no significant differences being recorded between the low-dose and high-dose OIT. 

Therefore, researchers concluded that in 80% of participants who experienced successful peanut reintroduction, both the low-dose and high-dose OIT were safe and equally effective at suppressing allergic immune responses to peanut.

Additionally, a comparison of the OIT-treated children with a control group of 154 non OIT treated peanut-allergic children, showed that children who underwent the peanut OIT treatment were 19 times more likely to successfully incorporate peanut into their diets in the future than the allergic children who had avoided peanut foods altogether.

The investigators are continuing to monitor the OIT-treated participants to assess the long-term treatment outcomes.

“A positive long-term result would likely lead to a focus on therapies for very young children with relatively recent onset of peanut, and perhaps other food, allergy.” Explained Plaut, “The success in this study is greater than in studies using older children and children with longer duration of food allergy. If it would be possible to be successful in young children, the approaches will be analyzed and will hopefully provide clues to increase the success in treating older children and adults.”

Currently, the NIAID-supported Immune Tolerance Network is conducting a randomized trial called IMPACT to determine whether peanut OIT can lower the risk of allergic reactions, induce tolerance and change the immune responses of peanut-allergic children aged 12 to 48 months.

by Hannah Gardiner