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Oral immunotherapy for peanut allergy: The con argument
Alessandro Fiocchi1, Maria Cristina Artesani1, Vincenzo Fierro1
1Allergy Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
The World Allergy Organization Journal
|March 5, 2021
Summary
Peanut oral immunotherapy (POIT) offers desensitization but carries risks. The decision to use POIT versus avoidance depends on individual patient and clinician risk-benefit assessments.
Area of Science:
- Allergy and Immunology
- Clinical Therapeutics
Background:
- Peanut allergy is a significant cause of anaphylaxis globally.
- Traditional management involves allergen avoidance.
- Oral peanut immunotherapy (POIT) is an alternative treatment approach.
Purpose of the Study:
- To review the benefits and side effects of POIT.
- To discuss the implications of a meta-analysis on POIT's downsides.
Main Methods:
- Systematic review of available POIT forms.
- Analysis of clinical discussions and meta-analysis findings.
Main Results:
- POIT's risk-benefit ratio varies; it favors treatment in some cases but not others.
- Patient and clinician values influence the decision-making process.
- Individuals unwilling to accept serious adverse effects may prefer avoidance.
Conclusions:
- POIT is an evolving treatment within a broader therapeutic landscape.
- Future options include sublingual, parenteral, and transcutaneous immunotherapy, as well as biologics.
Keywords:
EAACI, European academy of allergy asthma and immunologyEfficacyICER, Institute for clinical and economic reviewOFC, Oral food challengeOIT, Oral ImmunoTherapyOUtMATCH, Omalizumab as monotherapy and as adjunct therapy to multi-allergen OIT in Food allergic participantsOral immunotherapyPACE, Peanut allergen immunotherapy, clarifying the evidence meta-analysisPOISED, Peanut oral immunotherapy Study:Safety, efficacy and discoveryPOIT, Peanut oral ImmunoTherapyPeanut allergyQoL, Quality of lifeQuality of lifeSCIT, Subcutaneous immunotherapySLIT, Sublingual immunotherapySPT, Skin prick testSafety
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