PMID- 30225844
OWN - NLM
STAT- MEDLINE
DCOM- 20200313
LR  - 20200313
IS  - 1398-9995 (Electronic)
IS  - 0105-4538 (Linking)
VI  - 74
IP  - 2
DP  - 2019 Feb
TI  - Feasibility of desensitizing children highly allergic to peanut by high-dose oral 
      immunotherapy.
PG  - 337-348
LID - 10.1111/all.13604 [doi]
AB  - BACKGROUND: There are limited data on the feasibility, efficacy and safety of 
      high-dose oral immunotherapy (OIT) in children highly allergic to peanuts. 
      OBJECTIVE: In children highly allergic to peanut, we primarily aimed to determine 
      the feasibility of reaching the maximum maintenance dose (MMD) of 5000 mg peanut 
      protein or, alternatively, a lower individual maintenance dose (IMD), by OIT 
      up-dosing. Secondarily, we aimed to identify adverse events (AEs) and determine 
      factors associated with reaching a maintenance dose. METHODS: The TAKE-AWAY 
      peanut OIT trial enrolled 77 children 5-15 years old, with a positive oral peanut 
      challenge. Fifty-seven were randomized to OIT with biweekly dose step-up until 
      reaching MMD or IMD and 20 to observation only. Demographic and biological 
      characteristics, AEs, medication and protocol deviations were explored for 
      associations with reaching maintenance dose. RESULTS: All children had 
      anaphylaxis defined by objective symptoms in minimum two organ systems during 
      baseline challenge. The MMD was reached by 21.1%, while 54.4% reached an IMD of 
      median (minimum, maximum) 2700 (250, 4000) mg peanut protein, whereas 24.5% 
      discontinued OIT. During up-dosing, 19.4% experienced anaphylaxis. Not reaching 
      the MMD was caused by distaste for peanuts (66.7%), unacceptable AEs (26.7%) and 
      social reasons (6.7%). Increased peanut s-IgG(4) /s-IgE ratio (OR [95% CI]: 1.02 
      [1.00, 1.04]) was associated with reaching MMD. CONCLUSION: Although 75.5% of 
      children with peanut anaphylaxis reached a maintenance dose of 0.25-5 g, only 
      21.1% reached the MMD. Distaste for peanuts and AEs, including high risk of 
      anaphylaxis, limited the feasibility of reaching MMD.
CI  - (c) 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
FAU - Reier-Nilsen, Tonje
AU  - Reier-Nilsen T
AUID- ORCID: 0000-0001-8184-0607
AD  - Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, 
      Norway.
AD  - Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
FAU - Michelsen, Merethe Melbye
AU  - Michelsen MM
AD  - Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, 
      Norway.
AD  - Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
FAU - Lodrup Carlsen, Karin C
AU  - Lodrup Carlsen KC
AUID- ORCID: 0000-0002-9257-1198
AD  - Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, 
      Norway.
AD  - Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
FAU - Carlsen, Kai-Hakon
AU  - Carlsen KH
AD  - Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, 
      Norway.
AD  - Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
FAU - Mowinckel, Petter
AU  - Mowinckel P
AD  - Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, 
      Norway.
FAU - Nygaard, Unni C
AU  - Nygaard UC
AD  - Norwegian Institute of Public Health, Division for Infection Control and 
      Environmental Health, Oslo, Norway.
FAU - Namork, Ellen
AU  - Namork E
AD  - Norwegian Institute of Public Health, Division for Infection Control and 
      Environmental Health, Oslo, Norway.
FAU - Borres, Magnus P
AU  - Borres MP
AD  - Thermo Fisher Scientific, Uppsala, Sweden.
AD  - Institute of Maternal & Child Health, Uppsala University, Uppsala, Sweden.
FAU - Haland, Geir
AU  - Haland G
AD  - Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, 
      Norway.
AD  - Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
LA  - eng
SI  - ClinicalTrials.gov/NCT02457416
GR  - Extra Foundation/International
GR  - Kloster Foundation/International
GR  - South-Eastern Norway Regional Health Authority/International
GR  - Norwegian Asthma and Allergy Association/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20181008
PL  - Denmark
TA  - Allergy
JT  - Allergy
JID - 7804028
RN  - 0 (Allergens)
SB  - IM
CIN - Allergy. 2019 Feb;74(2):220-222. PMID: 30347127
MH  - Administration, Oral
MH  - Adolescent
MH  - Allergens/administration & dosage/*immunology
MH  - Arachis/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Comorbidity
MH  - *Desensitization, Immunologic/adverse effects/methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Peanut Hypersensitivity/diagnosis/*immunology/*therapy
MH  - Respiratory Function Tests
MH  - Risk Factors
MH  - Skin Tests
MH  - Treatment Outcome
OTO - NOTNLM
OT  - adverse events
OT  - desensitization
OT  - feasibility
OT  - oral immunotherapy
OT  - peanut allergy
EDAT- 2018/09/19 06:00
MHDA- 2020/03/14 06:00
CRDT- 2018/09/19 06:00
PHST- 2018/01/19 00:00 [received]
PHST- 2018/07/30 00:00 [revised]
PHST- 2018/08/12 00:00 [accepted]
PHST- 2018/09/19 06:00 [pubmed]
PHST- 2020/03/14 06:00 [medline]
PHST- 2018/09/19 06:00 [entrez]
AID - 10.1111/all.13604 [doi]
PST - ppublish
SO  - Allergy. 2019 Feb;74(2):337-348. doi: 10.1111/all.13604. Epub 2018 Oct 8.