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Peanut Sublingual Immunotherapy Safe, Effective

Findings show most children achieve clinically significant peanut desensitization from 4-mg dose over four years

By Lori Solomon HealthDay Reporter

MONDAY, April 3, 2023 (HealthDay News) — Peanut sublingual immunotherapy (SLIT) is safe in children and leads to clinically significant desensitization in most patients, according to a study published online Feb. 22 in the Journal of Allergy and Clinical Immunology.

Edwin H. Kim, M.D., from the University of North Carolina School of Medicine in Chapel Hill, and colleagues evaluated the efficacy and safety of 4-mg peanut SLIT and persistence of desensitization after SLIT discontinuation. The analysis included 47 peanut-allergic children (aged 1 to 11 years) treated for 48 months.

The researchers reported that the mean successfully consumed dose (SCD) during the placebo-controlled food challenge increased from 48 to 2,723 mg of peanut protein after SLIT, with 70 percent achieving clinically significant desensitization (SCD > 800 mg) and 36 percent achieving full desensitization (SCD = 5,000 mg). The median time to loss of clinically significant desensitization was 22 weeks. Compared with baseline, the peanut skin prick test; peanut-specific immunoglobulin (Ig)E, IgG4, and IgG4/IgE ratio; and peanut-stimulated basophil activation test, interleukin (IL)-4, IL-5, IL-13, interferon-γ, and IL-10 changed significantly, with changes seen as early as six months. Transient oropharyngeal itching was the most common reaction, with a median rate of reaction per dose of 0.5 percent and no dosing symptoms requiring epinephrine.

“In this open-label, prospective study, peanut SLIT was safe and induced clinically significant desensitization in most of the children, lasting more than 17 weeks after discontinuation of therapy,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

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