Two-year post-treatment outcomes following peanut oral immunotherapy in the Probiotic and Peanut Oral Immunotherapy-003 Long-Term (PPOIT-003LT) study.

IF 12.6 1区医学 Q1 ALLERGY Allergy Pub Date : 2024-10-01 Epub Date: 2024-08-04 DOI:10.1111/all.16262

Paxton Loke, Xiaofang Wang, Melanie Lloyd, Sarah E Ashley, Adriana C Lozinsky, Michael Gold, Michael D O'Sullivan, Patrick Quinn, Marnie Robinson, Audrey Dunn Galvin, Francesca Orsini, Mimi L K Tang

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Abstract

Background: Few studies have examined long-term outcomes following oral immunotherapy (OIT); none have examined long-term risks and benefits associated with distinct clinical outcomes (desensitization, remission).

Methods: Participants completing the probiotic and peanut oral immunotherapy (PPOIT) -003 randomized trial were enrolled in a follow-on study, PPOIT-003LT. Peanut ingestion, reactions, and health-related quality of life (HRQOL) were monitored prospectively. Outcomes at 1-year and 2-years post-treatment were examined by treatment group and by post-OIT clinical outcome (remission, desensitization without remission [DWR], allergic).

Results: 86% (151/176) of eligible children enrolled. Post-treatment peanut ingestion at 2-years post-treatment were similar for PPOIT (86.7%) and OIT (78.7%) groups, both higher than placebo (10.3%). Reactions reduced over time for all treatment and clinical outcome groups (PPOIT 31.7% to 23.3%, OIT 37.7% to 19.7%, placebo 13.8% to 6.9%; remission 27.5% to 15.9%; DWR 57.9% to 36.8%; allergic 11.6% to 7%). At 2-years post-treatment, similar proportions of remission and allergic participants reported reactions (RD 0.09 (95%CI -0.03, 0.20), p = .127), whereas more DWR participants reported reactions than remission (remission vs DWR: RD -0.21 (95%CI -0.39; -0.03), p = .02) and allergic (DWR vs allergic: RD 0.30 (95%CI 0.13, 0.47), p = .001) participants. At 2-years post-treatment, 0% remission versus 5.3% DWR versus 2.3% allergic participants reported adrenaline injector usage. Remission participants had significantly greater HRQOL improvement (adjusted for baseline) compared with both DWR (MD -0.54 (95%CI -0.99, -0.10), p = .017) and allergic (MD -0.82 (95%CI -1.25, -0.38), p < .001).

Conclusion: By 2-years post-treatment, remission participants reported fewer reactions, less severe reactions and greater HRQOL improvement compared with DWR and allergic participants, indicating that remission is the patient-preferred treatment outcome over desensitization or remaining allergic.

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益生菌和花生口服免疫疗法-003 长期（PPOIT-003LT）研究中花生口服免疫疗法两年后的治疗效果。

背景：很少有研究对口服免疫疗法（OIT）后的长期疗效进行研究：很少有研究对口服免疫疗法（OIT）的长期疗效进行研究；也没有研究对与不同临床疗效（脱敏、缓解）相关的长期风险和益处进行研究：方法：完成益生菌和花生口服免疫疗法（PPOIT）-003 随机试验的参与者被纳入后续研究 PPOIT-003LT。对花生摄入量、反应和健康相关生活质量（HRQOL）进行了前瞻性监测。按治疗组和OIT后临床结果（缓解、无缓解的脱敏[DWR]、过敏）对治疗后1年和2年的结果进行了研究：86%（151/176）符合条件的儿童参加了治疗。在治疗后 2 年，PPOIT 组（86.7%）和 OIT 组（78.7%）的花生摄入量相似，均高于安慰剂组（10.3%）。随着时间的推移，所有治疗组和临床结果组的反应都有所减少（PPOIT 31.7% 降至 23.3%，OIT 37.7% 降至 19.7%，安慰剂 13.8% 降至 6.9%；缓解 27.5% 降至 15.9%；DWR 57.9% 降至 36.8%；过敏 11.6% 降至 7%）。在治疗后 2 年，报告有反应的缓解期和过敏期参与者的比例相似（RD 0.09 (95%CI -0.03, 0.20)，p = .127），而报告有反应的 DWR 参与者多于缓解期（缓解期 vs DWR：RD -0.21 (95%CI -0.39; -0.03)，p = .02）和过敏期（DWR vs 过敏期：RD 0.30 (95%CI -0.39; -0.03)，p = .02）：RD：0.30 (95%CI 0.13, 0.47)，p = .001）。在治疗后 2 年，0% 的缓解参与者与 5.3% 的 DWR 参与者相比，2.3% 的过敏参与者报告使用了肾上腺素注射器。与 DWR（MD -0.54 (95%CI -0.99, -0.10)，p = .017）和过敏性参与者（MD -0.82 (95%CI -1.25, -0.38)，p 结论：与 DWR 和过敏性参与者相比，缓解期参与者的 HRQOL 改善幅度明显更大（根据基线调整）：在治疗后 2 年，与 DWR 和过敏参与者相比，缓解参与者报告的反应更少、反应更轻、HRQOL 改善更大，这表明缓解是患者更喜欢的治疗结果，而不是脱敏或继续过敏。

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来源期刊

Allergy 医学-过敏

CiteScore

26.10

自引率

9.70%

发文量

393

审稿时长

2 months

期刊介绍： Allergy is an international and multidisciplinary journal that aims to advance, impact, and communicate all aspects of the discipline of Allergy/Immunology. It publishes original articles, reviews, position papers, guidelines, editorials, news and commentaries, letters to the editors, and correspondences. The journal accepts articles based on their scientific merit and quality. Allergy seeks to maintain contact between basic and clinical Allergy/Immunology and encourages contributions from contributors and readers from all countries. In addition to its publication, Allergy also provides abstracting and indexing information. Some of the databases that include Allergy abstracts are Abstracts on Hygiene & Communicable Disease, Academic Search Alumni Edition, AgBiotech News & Information, AGRICOLA Database, Biological Abstracts, PubMed Dietary Supplement Subset, and Global Health, among others.