Infant and Toddler Peanut Oral Immunotherapy: Initiation Before Age 2 Increases Ad Libitum Peanut Consumption
Department
Allergy and Immunology
Document Type
Article
Publication Title
The Journal of Allergy and Clinical Immunology. In Practice
Abstract
Background: Peanut oral immunotherapy (POIT) has promising potential of disease modification, but there are no studies to date evaluating high-dose POIT, leading to ad libitum (ad lib) consumption of peanut products, especially in children 6 months to 4 years of age.
Objective: To report real-world outcomes of high-dose POIT in children 6 months to 4 years of age, including adverse events, achievement of ad lib consumption, and the impact of age on these outcome measures.
Methods: Patients 6 months to 4 years of age with a diagnosis of peanut allergy were enrolled in a POIT protocol with a goal dose of 3000 mg. Demographics along with POIT and clinical outcomes 6 months after POIT are reported.
Results: Sixty children, with a median age of 16 months, started POIT. Three (5%) were lost to follow-up, and 6 (10%) discontinued POIT because of recurrent adverse events or the inability to consume daily peanut protein. Fifty-one (85%) children completed POIT in a median of 7 months and were consuming ad lib peanut products for a duration of 6 months after completion of the POIT protocol. Sixteen (26.7%) children experienced a total of 22 adverse reactions during POIT. Initiating POIT before 24 months of age increased the likelihood of ad lib peanut consumption by an odds ratio of 11.69 (1.19-114.31, P = .035).
Conclusions: Our study demonstrates that high-dose POIT in infants and toddlers is well tolerated and can lead to ad lib introduction of dietary peanut products into the diet, especially if initiated before 2 years of age.
First Page
885
Last Page
892
DOI
10.1016/j.jaip.2025.01.032
Volume
13
Issue
4
Publication Date
4-1-2025
Medical Subject Headings
Humans; Peanut Hypersensitivity (therapy, immunology); Infant; Child, Preschool; Male; Female; Arachis (immunology); Administration, Oral; Desensitization, Immunologic (methods); Allergens (immunology); Treatment Outcome; Age Factors
PubMed ID
39921088
Recommended Citation
Mustafa, S. S., Capucilli, P., Tuong, L., Sanchez-Tejera, D., Vadamalai, K., & Ramsey, A. (2025). Infant and Toddler Peanut Oral Immunotherapy: Initiation Before Age 2 Increases Ad Libitum Peanut Consumption. The Journal of Allergy and Clinical Immunology. In Practice, 13 (4), 885-892. https://doi.org/10.1016/j.jaip.2025.01.032
