Peanut Consumption After Immunotherapy May Lower Reaction Risk

Consuming peanuts regularly after completing oral immunotherapy (OIT) or sublingual immunotherapy (SLIT) for peanut allergy may lessen the risk of allergic reaction from accidental exposure, according to new findings presented at the American Academy of Asthma, Allergy, and Immunology’s 2019 Annual Meeting.¹

“One of the big questions out there now is, ‘what does life after immunotherapy look like?’” said lead study author Edwin Kim, MD, assistant professor of medicine and pediatrics at the University of North Carolina (UNC) School of Medicine and director of the UNC Food Allergy Initiative, in a press release. “That’s what we were trying to answer with this research, and it appears that eating these small amounts of peanut is safe, can improve quality of life, and may help to maintain desensitization,” he said.²

Dr Kim and colleagues explored this further in a survey of 55 patients who had previously been desensitized to 300 mg to 5000 mg of peanut while participating in OIT or SLIT at UNC between 2010 and 2017. In the present study, participants were encouraged to consume approximately 300 mg of peanut per day

Of the participants, 65.5% reported allergies to other foods, 85% reported carrying an epinephrine autoinjector “often,” and 60% reported visiting an allergist annually.

Other key findings from the survey included:

• 89% reported continued peanut ingestion.
• 98% of parents “definitely” or “probably” felt their child was safer.
• 92.8% found their child’s quality of life had been improved.
• 94.5% of parents felt their own quality of life had improved.
• 87.3% of patients consumed products labeled “may contain peanut.”
• 92.7% of patients felt more comfortable eating at restaurants.
• 87.3% of parents were more comfortable with their kids being in unsupervised social settings.

The researchers noted that increased risk-taking behavior, such as not carrying an epinephrine autoinjector or not visiting an allergist annually, may be unintended consequences of this approach.

—Christina Vogt

References:

1. Yang L, Cook Q, Hamad A, et al. Back to life, back to reality — what happens after peanut immunotherapy? A long-term follow up study on perceptions of safety and lifestyle. J Allergy Clinical Immunol. 2019;143(2):AB246. https://doi.org/10.1016/j.jaci.2018.12.752.

2. Eating small amounts of peanut after immunotherapy may extend allergy treatment benefits [press release]. San Francisco, CA. University of North Carolina School of Medicine. February 24, 2019. https://www.newswise.com/articles/eating-small-amounts-of-peanut-after-immunotherapy-may-extend-allergy-treatment-benefits. Accessed on February 25, 2019.