Peanut Sublingual Immunotherapy in toddler-age found to be S
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Studies of peanut sublingual immunotherapy (PNSLIT) have suggested improving desensitization with younger age of initiation.

Food challenge confirmed peanut-allergic children ages 1-4
years with positive peanut-specific IgE and skin prick test (SPT) were randomized 1:1 to receive PNSLIT at a daily maintenance dose of 4mg peanut protein versus placebo for 36 months. Desensitization was assessed by double-blind, placebo-controlled food challenge (DBPCFC) to 4333mg
of peanut protein. Sustained unresponsiveness (SU) was assessed by identical DBPCFC after discontinuing PNSLIT for 3 months. Dosing compliance and side effects were recorded on home diaries.

--55 participants (median age 2.2 years) were randomized at 2
academic centers. The groups were similar across gender, race, ethnicity, atopic history, peanut SPT, and qualifying DBPCFC.

--Of 36 participants (19 PNSLIT, 17 placebo) completing the desensitization DBPCFC, cumulative tolerated dose increased from median 143mg to 4443mg in the PNSLIT group and 43mg to 143mg in the placebo group.

--14 PNSLIT participants passed the desensitization DBPCFC and 12 passed the SU DBPCFC compared to 0 desensitization and 2 SU in the placeb group.

--Peanut SPT decreased from 10mm to 3.25mm PNSLIT versus 11.5mm to 12mm with placebo. Symptoms were reported with 1031 PNSLIT doses versus 629 placebo doses with over 20000 doses taken.

Conclusively, Significant desensitization was observed with PNSLIT in peanut-allergic toddlers when compared to placebo with a strong potential for SU. PNSLIT may be a promising treatment option for early intervention in peanut allergy.

Source: Advance/journals/ymai/AAAAI_2021_LateBreaking_Abstracts.pdf