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Updated: Aug 26, 2025

Basophil Activation Test for Allergy Diagnosis
Published on: May 31, 2021
Current and future treatments for peanut allergy
Tricia Lee1,2, Sofia Edwards-Salmon2, Brian P Vickery1,2
1Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Insights
Peanut allergy (PA) treatments are evolving beyond historical limitations. Peanut oral immunotherapy (POIT) is now a viable option, with new approaches like epicutaneous immunotherapy and biologics also under investigation for PA.
Area of Science:
- Allergy and Immunology
- Pediatric Medicine
- Pharmacology
Background:
- Peanut allergy (PA) is a prevalent and challenging childhood condition often persisting into adulthood.
- Historically, effective treatments for PA were unavailable, significantly impacting patients' quality of life.
- Recent advancements are transforming the therapeutic landscape for peanut allergy.
Purpose of the Study:
- To review the current and emerging therapeutic interventions for peanut allergy (PA).
- To discuss the growing role and evidence supporting peanut oral immunotherapy (POIT), including FDA-approved options.
- To explore alternative immunotherapy approaches and biologic agents in development for PA.
Main Methods:
- Review of current literature on peanut allergy treatments.
- Analysis of clinical evidence for peanut oral immunotherapy (POIT) and other immunotherapies.
- Examination of data on biologic agents, such as Omalizumab, in PA management.
Main Results:
- Peanut oral immunotherapy (POIT) is increasingly accepted, particularly in preschoolers, demonstrating safety and feasibility.
- Several alternative immunotherapy methods (epicutaneous, sublingual, subcutaneous, intralymphatic) are under investigation.
- Biologic therapies, including Omalizumab, show promise as adjunctive treatments or monotherapy for PA.
Conclusions:
- The treatment paradigm for peanut allergy is shifting towards active interventions.
- Allergists must engage in shared decision-making, considering patient goals and evaluating risks/benefits of diverse therapies.
- A future with multiple therapeutic choices for PA necessitates informed clinical judgment.
Abstract:
Peanut allergy (PA) is a common, burdensome childhood disease that in most patients continues into adulthood and has historically been untreatable. However, peanut oral immunotherapy (POIT) is increasingly being incorporated into allergy practices, using both the first FDA-approved product, PTAH (previously AR101; Palforzia™, Aimmune Therapeutics), as well as store-bought peanut products. POIT in preschoolers continues to gain more acceptance as evidence accrues that it is a safe and feasible approach that may have distinct advantages. There are many new therapeutic interventions currently under study with a variety of different approaches and potential mechanisms. With respect to other forms of immunotherapy, none are currently approved, but the epicutaneous approach is the most well-studied and others are being actively investigated, including sublingual, subcutaneous, and intralymphatic. Biologics are gaining evidence both as adjunctive treatments to POIT and as monotherapy. Omalizumab is the most widely studied biologic for PA but others also have potential. Looking ahead to a future therapeutic landscape of choice, allergists will need to understand each patient's goal of treatment through shared decision-making and fully evaluate the risks, benefits, and alternatives of each new therapy.
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