Posted on 04/27/2025 12:07:50 PM PDT by Red Badger
A pioneering trial shows that adults with severe peanut allergies can build up a tolerance through supervised daily exposure, freeing many from lifelong fear.
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Adults living with the fear of severe peanut allergies might finally have hope. A groundbreaking trial has shown that carefully supervised daily peanut exposure can desensitize most adults, allowing them to eat peanuts without a reaction.
The GUPI trial, the first to focus solely on adults, revealed that two-thirds of participants could safely consume the equivalent of five peanuts after gradual dose increases. Many reported dramatic improvements in quality of life, shedding years of fear and anxiety, with some calling the experience “life-changing.”
Promising Breakthrough in Peanut Allergy Desensitization
The first clinical trial to test whether adults with peanut allergies can be desensitized has delivered promising results. In the study, two-thirds of participants were able to consume the equivalent of five peanuts without experiencing an allergic reaction.
Known as the Grown Up Peanut Immunotherapy (GUPI) trial, this is the first study conducted exclusively in adults with severe peanut allergies. It tested whether daily, carefully supervised doses of peanuts could be safely tolerated over time.
The method, called oral immunotherapy, has already proven effective in infants and children through previous trials around the world. Now, this new adult-focused research has been published in the journal Allergy by a team from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust. The study was funded by the National Institute for Health and Care Research (NIHR) through its Research for Patient Benefit Programme.
Relieving the Burden of Constant Fear
Professor Stephen Till, Chief Investigator and Professor of Allergy at King’s College London, explained: “Constant fear of life-threatening reactions places a huge burden on people with peanut allergy. The only way to manage a peanut allergy is strict avoidance and treatment of allergic reactions, including with adrenaline.
“Although peanut immunotherapy is known to be effective in children, this trial provides preliminary evidence that adults can also be desensitised and that this improves quality of life. The average tolerated dose of peanuts increased 100-fold over the course of the trial.”
The Phase II trial recruited twenty-one adults between 18 and 40 with a clinical diagnosis of peanut allergy at Guy’s and St Thomas’ NHS Foundation Trust. Allergy was confirmed via skin prick test, blood test, and then an oral food challenge.
Carefully Monitored Early Dosing
In a clinical setting, participants received the first dose of 0.8mg peanut flour mixed in with food, then 1.5 mg 30 minutes later followed by 3mg a further 30 minutes later.
Participants who tolerated 1.5mg or 3mg of peanut flour continued on a daily dose at home for 2 weeks. This is the equivalent of 0.5-1% of a whole peanut.
Then participants returned at 2-weekly intervals for supervised doses of more peanut protein, increasing from 6mg (around 1/40th of a whole peanut) to 1g (four whole peanuts). If participants could tolerate 50-100mg of peanut protein, participants were switched to eating whole peanuts, peanut butter or peanut products, with the first dose being under supervision of the clinical team.
Testing Final Tolerance and Daily Maintenance
Once participants achieved a daily dose of 1g, they remained on this dose for at least four weeks before undergoing a double‐blind placebo‐controlled food challenge. This involved being given increasing doses of either peanut or placebo (dummy) on separate days under close supervision to test their tolerance. Participants then continued daily dosing for at least three months before exiting the trial as well as the option of continuing post-study.
Results showed that 67% of participants were able to consume at least 1.4g of peanut protein – the equivalent of five peanuts – without reacting. Participants of the trial could then consume peanuts every day at home to remain desensitized.
Professor Till said: “We are very pleased with the results. The efficacy rate is broadly in line with peanut oral immunotherapy trials in children. The next stage of the research will be confirming this in larger trials, and also identifying the group of adult patients who would most likely benefit from oral immunotherapy, and see whether it can lead to long-term tolerance in this age group.”
Life-Changing Impact on Quality of Life
Lead author specialist Allergy Dietitian Hannah Hunter from Guy’s and St Thomas’ NHS Foundation Trust said: “Living with peanut allergy is a huge burden due to the need for constant vigilance and the risk of accidental exposures. Everyday situations such as eating in restaurants and social events are anxiety-provoking, and our patients tell us that the condition also affects travel choices and career options. We found that quality of life significantly improved after oral immunotherapy, and fear of food also decreased. Many participants who completed the trial told us that the treatment had been life-changing and they were no longer living in fear.”
A Participant’s Perspective: Freedom from Fear
Chris, 28, took part in the trial. He was diagnosed with a peanut allergy as a baby and jumped at the chance of taking part in the trial.
He said, “I’m so proud to have been part of this trial and so happy to say that I used to be allergic to peanuts, but thanks to this trial, this is no longer a concern. My family and I were always anxious that even a trace of peanut could be life-threatening. The trial was an interesting experience because all of my life, I had associated the taste and smell of peanuts with fear and death.
“I started with a small amount of peanut flour with yogurt, and by the end of the trial, I could eat four peanuts in one sitting. Now, I have four peanuts every day with my breakfast to maintain my immunity. Before, a tiny mistake could have life-threatening impacts, but now I don’t have the fear that I might collapse and die from eating a takeaway.”
Reference:
“Oral Immunotherapy in Peanut-Allergic Adults Using Real-World Materials”
by Hannah Hunter, Kok Loong Ue, Victoria Cornelius, Ching Ching Yung, Iason Thomas, Olympia Tsilochristou, Janice Layhadi, Leonard Q. C. Siew, Carina Venter, Mohamed H. Shamji and Stephen J. Till, 23 April 2025, Allergy.
DOI: 10.1111/all.16493
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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