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Children undergoing immunotherapy for peanut allergies may achieve the same results with a lower dose.
According to new research from The Hospital for Sick Children (SickKids) and Montreal Children’s Hospital, a smaller dose of peanut oral immunotherapy (OIT) can offer fewer side effects than the current standard treatment while still helping lower the risk of severe allergic reactions if a child is accidentally exposed to peanuts.
These findings were published in the Journal of Allergy and Clinical Immunology – In Practice.
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What is Peanut Oral Immunotherapy?
According to the study, about 2 percent of children in Canada have peanut allergies. This is also similar to the U.S., where about 2 to 5 percent of children have allergic reactions to peanuts, according to University Hospitals.
However, peanut OIT may provide some benefit to children with peanut allergies. Peanut OIT involves feeding a patient a specified amount of peanut protein. Over time, the dose is gradually increased until the patient reaches a maintenance dose, which is then administered regularly after treatment to reduce the effects of peanut allergy.
OIT can be a beneficial treatment for children. But the standard doses are rather large, and the treatment time can be lengthy. Treatments must be monitored by a medical professional as they can lead to anaphylaxis. Because of this, and because a child may dislike the taste of OIT, patients may discontinue the treatment.
As such, the researchers hope that by lowering the dose, they can help make treatments more accessible to patients.
Lowering the Dosage
For this study, the research team separated 51 children with peanut allergies into three distinct treatment groups:
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A low-dose group with 30 mg as the maintenance dose
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A standard-dose group with 300 mg as the maintenance dose
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An avoidance group with no OIT administered
The results showed that each OIT group exhibited similar increases in allergic reaction tolerance, whereas those in the avoidance group showed little change.
“We were excited to find that peanut OIT maintenance doses can be much lower than previously thought and still contribute to positive outcomes,” said Julia Upton, Head of the Division of Immunology & Allergy, Project Investigator in the SickKids Research Institute, Co-Director of the SickKids Food Allergy and Anaphylaxis Program, and co-first author of the study, in a press release. “The more options we have, the more we can support patients’ experience and provide meaningful, tailored care.”
A Potential New Treatment Option
The results also showed that patients in the low-dose treatment group experienced fewer severe reactions than those in the standard-dose group. The study authors also note that none of the children in the low-dose group discontinued treatment.
“This is a small enough dose that even children who do not like the taste can continue treatment,” said co-senior study author Thomas Eiwegger, Adjunct Scientist in the Translational Medicine program, in a press release. “This is the first time we’ve compared standard doses to such a low dose, but the minimum maintenance dose to provide benefit may be even lower than 30mg.”
The research team hopes that this additional treatment option could make OIT treatments more accessible to more children with peanut allergies, though ultimately, the treatment decision comes down to the patient and their parents or guardians. According to the study, some children may remain on the lower dose, while others may receive the higher dose; this depends on the patient’s goals.
“The study found that very small amounts of peanuts, that are associated with less reactions, could be used as effectively as large amounts for oral immunotherapy, making it safer and accessible to more Canadians, even those who are very sensitive to the allergen,” concluded Moshe Ben-Shoshan, co-senior author of the study, a paediatric allergy and immunology specialist at the Montreal Children’s Hospital and Scientist in the Infectious Diseases and Immunity in Global Health Program at the Research Institute of the McGill University Health Centre, in a press release.
This article is not offering medical advice and should be used for informational purposes only.
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Article Sources
Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:
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This article references information from a recent study published in the Journal of Allergy and Clinical Immunology – In Practice: Peanut Oral Immunotherapy Using 30 and 300 mg Maintenance Doses
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This article references information from University Hospitals: A Breakthrough for Kids With Peanut Allergies
