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According to new research, preschoolers can safely undergo oral immunotherapy (OIT) for peanut allergies.
ILO is designed to bring patients to a point of desensitization to food. The therapy has been tested in older children, but new research from researchers at the University of British Columbia and BC Children's Hospital is the first to make sure that therapy is safe for children from the very beginning. 9 months old.
"Many allergists do not believe that the ILO should be offered outside the research community and have not consistently proposed it as a treatment for peanut allergy in their clinics for reasons of security, "said Edmond S. Chan, MD, senior author of the study, a statement. "We hope our data demonstrates that the treatment is safe for preschool children and that it could be offered to preschool-age children allergic to peanuts who request it." . "
Chan and his colleagues recruited 270 patients aged 9 months to 5 years for a peanut OIT in 2017 and 2018. To be included, patients had to have a well established allergy to peanut. Twenty-seven patients gave up, leaving 243 patients to complete the study.
The children in the study consulted a pediatric allergist every two weeks in a clinic or hospital where they received a dose of peanut protein. The parents then administered daily doses at home between visits. The goal was to bring the child to a maintenance dose of 300 mg of peanut protein after 8 to 11 visits.
Two-thirds of the children in the study (67.8%) had a reaction to the peanut protein, but two-thirds of these reactions were mild or moderate. Eleven patients experienced reactions severe enough to warrant the administration of a dose of epinephrine (2.2% of the reactions).
Corresponding author Lianne Soller, Ph.D., from the University of British Columbia, said MD Magazine® The parents were carefully informed and trained on the dosing procedures before asking them to administer the peanut protein to the house.
"The allergist would talk with the family about the risk of reaction and ensure that Epipen was always available in case of a reaction," she said. "The family also received a sheet of instructions on what to do if a reaction occurred at home."
Soller said that home administration was a key aspect of the therapy, and that most parents were in agreement with the process once it was explained to them. Thanks to the data from the study, allergists can now say concretely to parents that the risk of a severe reaction is very low.
The results raise the hope that children allergic to peanuts could be cured and would no longer require extreme precautions to avoid contact with products containing peanuts. The question of whether these patients will eventually be "cured" remains an open question, no long-term study of peanut IOT in preschool children having been completed.
"The hope is that by staying on ILO (eating the peanut dose every day), if the child accidentally ate something containing peanuts, he would not have a reaction or his reaction would be mild," he said. Soller. "But we still do not know for sure if this is the case, as our study looked at safety only during the first months of treatment by ILO."
The study, "Initial Analysis of the Real Safety of Preschool Pediatric Oral Immunotherapy in the Real World," was published online in The journal of allergies and clinical immunology: in practice.
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