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Sublingual immunotherapy for peanut allergy: a randomized, double-blind, placebo-controlled multicenter trial
David M Fleischer1, A Wesley Burks, Brian P Vickery
1Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA. Fleischerd@njhealth.org
The Journal of Allergy and Clinical Immunology
|December 26, 2012
Summary
Peanut sublingual immunotherapy (SLIT) safely improved tolerance in most participants, increasing the amount of peanut they could consume without reaction. Longer treatment durations further enhanced these positive outcomes.
Area of Science:
- Allergy and Immunology
- Clinical Therapeutics
- Food Hypersensitivities
Background:
- No current treatments exist for peanut allergy.
- Peanut allergy affects a significant population, necessitating therapeutic options.
Purpose of the Study:
- To evaluate the safety and efficacy of peanut sublingual immunotherapy (SLIT).
- To assess the immunologic effects of peanut SLIT.
Main Methods:
- 40 participants (aged 12-37) received daily peanut or placebo SLIT for 44 weeks.
- Oral food challenges (OFCs) measured the successfully consumed dose (SCD) of peanut powder at baseline and after treatment.
- Placebo group crossed over to peanut SLIT, with subsequent OFCs.
Main Results:
- 70% of peanut SLIT recipients were responders vs. 15% in the placebo group (P < .001).
- Median SCD increased significantly in responders after 44 weeks (3.5 to 496 mg) and 68 weeks (to 996 mg).
- 95.2% of peanut doses were symptom-free, excluding oral-pharyngeal symptoms.
Conclusions:
- Peanut SLIT demonstrated safety and induced desensitization in most subjects compared to placebo.
- Extended SLIT duration led to statistically significant increases in peanut SCD.
