The safety of peanut oral immunotherapy in peanut-allergic subjects in a single-center trial

Abstract

Background: Peanut allergy is the leading cause of food-related anaphylaxis, and accidental exposures are common. Oral immunotherapy (OIT) has been posited as a potential treatment.

Methods: Patients aged 3-65 years with peanut-specific IgE ≥7 kU/l and/or a positive skin prick test with a history of an allergic reaction to peanut were recruited to undergo an OIT protocol. All adverse reactions were recorded by research staff or patients in real time.

Results: Twenty-four patients received 6,662 doses. Symptoms were mostly mild (84%), and only 3 severe gastrointestinal reactions required the administration of epinephrine. Abdominal pain was the most common reaction, followed by oropharyngeal and lip pruritus. Respiratory symptoms were rare.

Conclusions: In this trial of OIT in adults and children, most reactions were mild.

Fig. 1

Total number of symptoms are depicted by type of symptom and in what situation the reaction occurred (during the modified rush day, during a dose escalation appointment or at home).

Fig. 2

The above graph demonstrates the percentage of doses at each dose level that resulted in any reaction (line). Reactions are categorized by the patient (for home doses) or practitioner (for doses in the CTRU) as mild, moderate, or severe. (8) Doses on the X axis are in milligrams of peanut protein.