Infant and Toddler Peanut Oral Immunotherapy: Initiation Before Age 2 Increases Ad-Lib Peanut Consumption.

IF 8.2 1区医学 Q1 ALLERGY Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-02-05 DOI:10.1016/j.jaip.2025.01.032

S Shahzad Mustafa, Peter Capucilli, Linh-An Tuong, Denise Sanchez-Tejera, Karthik Vadamalai, Allison Ramsey

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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-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 age 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 (PA) were enrolled in a POIT protocol with goal dose of 3000 mg. Demographics, along with POIT and clinical outcomes 6 months after POIT are reported.

Results: Sixty children started POIT, with a median age of 16 months. Three (5%) were lost to follow up, and 6 (10%) discontinued POIT due to recurrent adverse events or 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 prior to 24 months of age increased the likelihood of ad-lib peanut consumption by an odds ratio of 11.69 (1.19-114.31, p=0.035).

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 two years of age.

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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.