The potential benefits of prolonging oral immunotherapy in peanut allergy patients
If you know anyone with peanut allergy, you’ll hear their questions about peanuts while eating out in restaurants. Accidental ingestion could cause symptoms varying in severity from runny nose, rash, difficulty breathing to even severe life threatening events like anaphylaxis.
Food allergy in America accounts about 8% of children and 4% of adults in the United States. Children with peanut allergy tend to be more 2- 4 times likely to have asthma and other food allergies compared to other children without food allergies.
Oral immunotherapy, a treatment by starting small amount of peanut protein to patients to train their immune system to accept peanut by gradually tapering up the dose of peanut protein.The old studies proved the clinical significance of the treatment. However, the side effects, optimal duration or dose of oral immunotherapy remains poorly known.
A new study published in The Lancet by researchers from Stanford University looked into the sustained effect of oral immunotherapy.
Scientists tested 120 subjects aged between 7–55 years old with peanut allergy. The subjects were randomly assigned into 3 groups.
The first group received 4000 mg peanut protein for 104 weeks and stop giving on peanut after that (peanut 0 group, n=60 subjects).
The second group was maintained on 4000 mg of peanut protein for 104 weeks then given 300 mg peanut protein once a day for another 52 weeks (peanut 300 group, n=35 subjects).
The placebo group only receive oat flour (placebo group, n=25 subjects).
The result showed that about 83% of subjects in immunotherapy group successfully tolerated the peanut challenge versus 4% of subjects in placebo group.
When comparing the outcome between the peanut 0 group to peanut 300 group after 52 weeks, the study found that subjects in peanut 300 group performed better in passing the peanut challenge than those in peanut 0 group, with 37% vs 13% respectively.
Therefore, by analyzing the outcome data from the study, the researchers concluded that peanut oral immunotherapy with the dose of 4000 mg could successfully reduce the likelihood of having peanut allergy. However, the effect of suppressing the peanut allergy could diminish if reduce the dose to 300 mg daily or stop the therapy completely after one year treatment.
For more information, please visit The Lancet.
Questions: Do you have any food allergies? How is this research helpful to patients with other food allergies?
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