PMID- 38428524
OWN - NLM
STAT- Publisher
LR  - 20240404
IS  - 2213-2201 (Electronic)
DP  - 2024 Feb 28
TI  - High Degree of Desensitization After 1 Year of Early-Life Peanut Oral 
      Immunotherapy: Small Children Oral Immunotherapy (SmaChO) Randomized Controlled 
      Trial.
LID - S2213-2198(24)00204-6 [pii]
LID - 10.1016/j.jaip.2024.02.030 [doi]
AB  - BACKGROUND: The prevalence of peanut allergy is about 2% and mostly lifelong. 
      Studies of oral immunotherapy (OIT) with peanut (the daily oral intake of an 
      initially low and then increasing dose of peanut) often show problematic side 
      effects, but there are indications of better safety and effect in younger 
      children compared with older children and adults. OBJECTIVE: To determine the 
      safety and effectiveness of peanut OIT with a slow up-dosing strategy and low 
      maintenance dose in children aged 1 to 3 years who were allergic to peanut, 
      through a 1-year interim analysis. METHOD: In a randomized controlled trial (2:1 
      ratio), 75 children, median age 31 months (interquartile range [IQR], 23-40 
      months) were assigned to receive peanut OIT (n = 50) or peanut avoidance (n = 
      25). RESULTS: In the OIT and avoidance groups, 43 of 50 and 20 of 25 children, 
      respectively, performed the 1-year open oral peanut challenge. A cumulative dose 
      of 750 mg peanut protein after 1 year was tolerated by 72% (36 of 50 children) in 
      the OIT group compared with 4% (1 of 25) in the avoidance group (P < .001). 
      Median tolerated cumulative dose was 2,750 mg (IQR, 275-5,000 mg) peanut protein 
      in the OIT group compared with 2.8 mg (IQR, 0.3-27.8 mg) in the avoidance group 
      (P < .001). Of the doses administered at home during the first year of OIT, 1.4% 
      resulted in adverse events and 79% were mild, and three doses of epinephrine were 
      given at home to two individuals. CONCLUSION: In children aged 1 to 3 years, 
      peanut OIT with the combination of slow up-dosing and low maintenance dose seems 
      safe and effective after 1 year.
CI  - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Uhl, Carina
AU  - Uhl C
AD  - Department of Clinical Science and Education, Sodersjukhuset, Karolinska 
      Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, 
      Sodersjukhuset, Stockholm, Sweden.
FAU - Klevebro, Susanna
AU  - Klevebro S
AD  - Department of Clinical Science and Education, Sodersjukhuset, Karolinska 
      Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, 
      Sodersjukhuset, Stockholm, Sweden. Electronic address: susanna.klevebro@ki.se.
FAU - Sverremark-Ekstrom, Eva
AU  - Sverremark-Ekstrom E
AD  - Department of Molecular Biosciences, Wenner-Gren Institute, Stockholm University, 
      Stockholm, Sweden.
FAU - Tedner, Sandra G
AU  - Tedner SG
AD  - Department of Women's and Children's Health, Karolinska Institutet, Stockholm, 
      Sweden.
FAU - Brandstrom, Josef
AU  - Brandstrom J
AD  - Department of Neonatology, Astrid Lindgrens Childrens Hospital, Karolinska 
      University Hospital, Stockholm, Sweden.
FAU - Papageorgiou, Chrystalleni
AU  - Papageorgiou C
AD  - Department of Clinical Science and Education, Sodersjukhuset, Karolinska 
      Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, 
      Sodersjukhuset, Stockholm, Sweden.
FAU - Melen, Erik
AU  - Melen E
AD  - Department of Clinical Science and Education, Sodersjukhuset, Karolinska 
      Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, 
      Sodersjukhuset, Stockholm, Sweden.
FAU - Konradsen, Jon R
AU  - Konradsen JR
AD  - Department of Women's and Children's Health, Karolinska Institutet, Stockholm, 
      Sweden; Pediatric Allergy and Pulmonology Unit, Astrid Lindgren Children's 
      Hospital, Karolinska University Hospital, Stockholm, Sweden.
FAU - Nilsson, Caroline
AU  - Nilsson C
AD  - Department of Clinical Science and Education, Sodersjukhuset, Karolinska 
      Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, 
      Sodersjukhuset, Stockholm, Sweden.
FAU - Asarnoj, Anna
AU  - Asarnoj A
AD  - Department of Women's and Children's Health, Karolinska Institutet, Stockholm, 
      Sweden; Pediatric Allergy and Pulmonology Unit, Astrid Lindgren Children's 
      Hospital, Karolinska University Hospital, Stockholm, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20240228
PL  - United States
TA  - J Allergy Clin Immunol Pract
JT  - The journal of allergy and clinical immunology. In practice
JID - 101597220
SB  - IM
OTO - NOTNLM
OT  - Ara h 2
OT  - Children
OT  - Food allergy
OT  - Oral immunotherapy
OT  - Oral peanut challenge
OT  - Peanut allergy
OT  - Treatment
EDAT- 2024/03/02 10:42
MHDA- 2024/03/02 10:42
CRDT- 2024/03/01 19:14
PHST- 2023/12/12 00:00 [received]
PHST- 2024/02/02 00:00 [revised]
PHST- 2024/02/21 00:00 [accepted]
PHST- 2024/03/02 10:42 [pubmed]
PHST- 2024/03/02 10:42 [medline]
PHST- 2024/03/01 19:14 [entrez]
AID - S2213-2198(24)00204-6 [pii]
AID - 10.1016/j.jaip.2024.02.030 [doi]
PST - aheadofprint
SO  - J Allergy Clin Immunol Pract. 2024 Feb 28:S2213-2198(24)00204-6. doi: 
      10.1016/j.jaip.2024.02.030.