Posted on 04/27/2025 12:07:50 PM PDT by Red Badger
https://onlinelibrary.wiley.com/doi/10.1111/all.16493
ABSTRACT
Background
Peanut oral immunotherapy (OIT) has shown effectiveness in achieving desensitization of children; however, evidence in adults is lacking.
Methods
This phase II trial evaluated peanut OIT in peanut-allergic adults using real-world peanut products. A Simon’s minimax two-stage design, incorporating a stop:go for futility, was employed. A separate untreated control group was also recruited for comparison of mechanistic parameters. Participants underwent baseline double-blind placebo-control food challenges (DBPCFC) with peanut protein doses of 0.3 to 300 mg. Reacting participants were initiated on daily OIT with 2-weekly updosing until reaching a maintenance dose of 1000 mg (four large peanuts). The primary outcome was the proportion of OIT participants who tolerated a cumulative dose of 1.4 g peanut protein during exit DBPCFC (doses provided 0.3-3000 mg).
Results
Twenty-one adults (8 female; mean age 24.2 years [SD 4.9]) were enrolled in the OIT group, with 67% achieving the daily maintenance dose and meeting the primary endpoint. Three withdrew due to adverse reactions, and a further three did not complete the trial for reasons unrelated to OIT. The median tolerated dose increased from 30 mg (equivalent to approximately 1/8th of a peanut) to 3000 mg (12 peanuts) at the exit challenge, representing a 100-fold increase (p < 0.0001). OIT was associated with an improvement in QoL measures. Suppression of peanut skin prick test sizes and induction of peanut-specific IgG were observed in OIT but not in control participants.
Conclusions
Peanut OIT appears to be an efficacious treatment for adults with peanut allergy. Further studies are needed for confirmation and to characterize safety profiles in different adult subgroups.
Trial Registration
Grown Up Peanut Immunotherapy (GUPI) study; ClinicalTrials.gov identifier: NCT03648320
Graphical Abstract
In 21 adults initiated on peanut oral immunotherapy (OIT), 67% tolerated at least 1000 mg on exit DBPCFC. Decreases in SPT size and increases in peanut- and Ara h 2-specific IgG occurred in OIT participants but not in mechanistic controls (n = 9). Improvements were seen in FAQLQ-AF and food neophobia scores. Epinephrine was used infrequently; the majority (94.5%) of adverse reactions were mild (grade 1). AF, food allergy quality of life questionnaire—adult form; DBPCFC, double-blind, placebo-controlled food challenge; FAQLQ-OIT, oral immunotherapy; QoL, quality of life; SPT, skin prick test.
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I’ve heard of worse medical requirements to survive than having to eat REESE’S Peanut Butter Cups everyday.
If they would take Diamine Oxidase Enzyme, they most likely would have accelerated the desensitization process.
Reminds me of a guy who does videos on YouTube called “Venom Guy”. Microdosed himself with many different snake venoms in increasing amounts to the point that he gan take bites from a king cobra and black mamba at th3 same time and suffer no real effects.
Thanks very much for posting this, RB. I have a relative who won’t even enter a place where there are peanuts. Maybe this can help.
“He Nearly Died From a Peanut Allergy – Now He Eats Them for Breakfast”
I thought he stopped believing Western Media.
“If they would take Diamine Oxidase Enzyme, they most likely would have accelerated the desensitization process.”
It could work in the opposite manner introducing another variable.
So can we bring them back to airline flights?
“I thought he stopped believing Western Media.”
Thought?
I’m certain there will be Pfizer vax for pnut allergies.
Not unless everybody in the world gets the treatment...............Can you bring your own?.............
AFAIK you are not told not to, but if you break them out and somebody complains, watch out!
AFAIK you are not told not to, but if you break them out and somebody complains, watch out!
https://www.poemtree.com/poems/TerenceThisIsStupidStuff.htm
There was a king reigned in the East:
There, when kings will sit to feast,
They get their fill before they think
With poisoned meat and poisoned drink.
He gathered all that sprang to birth
From the many-venomed earth;
First a little, thence to more,
He sampled all her killing store;
And easy, smiling, seasoned sound,
Sate the king when healths went round.
They put arsenic in his meat
And stared aghast to watch him eat;
They poured strychnine in his cup
And shook to see him drink it up:
They shook, they stared as white's their shirt:
Them it was their poison hurt.
—I tell the tale that I heard told.
Mithridates, he died old.
Everything that's old is new again.
I know someone who was in one of these trials and he is indeed able to tolerate peanuts now. They did the sublingual drop therapy to desensitize him.
I could not believe they could create a dose low or weak enough for him to be able to start it, his allergies were so bad, but they did and he is now desensitized.
I highly doubt it, but yes it is possible.
Diamine Oxidase Enzyme degrades the histamines in the body. I’ve never known anyone to be allergic to it as it is in a mother’s placenta and breast milk.
Since the peanut allergy is a histamine response, it should help.
He hates peanuts because of the food aversion issue, associating them with his horrific responses, but he is no longer in danger from anaphylaxis from accidental exposure.
“Since the peanut allergy is a histamine response, it should help.”
It helps reduce the allergy response but that may interfere with the desensitization process.
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