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Peanut Immunotherapy: Practical Applications

  • Specific Immunotherapy (L Cox, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Opinion statement

Purpose of review

The recent approval of the first commercial peanut oral immunotherapy formulation ushered a new era of clinical food allergy treatment. With different options for peanut immunotherapy available, it is important review the evidence of efficacy, risks, and unique considerations for the individual modalities.

Recent findings

Oral immunotherapy (OIT), epicutaneous immunotherapy (EPIT), and sublingual immunotherapy (SLIT) for peanut allergy have risen as possible treatments for peanut allergy. Numerous studies indicate that OIT effectively desensitizes by increasing the amount of peanut protein than can be consumed without symptoms. While this desensitization is to increased amounts of peanut protein when compared to SLIT or EPIT, OIT appears to have greater risk for anaphylaxis and other adverse events. EPIT has the unique benefit of a single-dose patch without the need for in-clinic visits for dose escalation, and it bypasses the oral route which may be advantageous in certain patients. The impact of peanut immunotherapy on health-related quality of life is not well studied and current data is conflicting, but suggests that improvement in certain domains of QOL, especially for caregivers of children with peanut allergy, may be an important target for immunotherapy.

Summary

This review focuses on the data for efficacy, safety, and tolerability of OIT, SLIT, and EPIT with the aim of presenting information that will assist allergy practitioners in choosing an immunotherapy modality when indicated.

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  1. University of North Carolina School of Medicine, 3004 Mary Ellen Jones Bldg, 116 Manning Dr, CB 8035, Chapel Hill, NC, 27599, USA

    Olivia Francis MD & Edwin H. Kim MD, MS

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Olivia Francis declares no conflict of interest.

Edwin Kim reports personal fees and non-financial support from DBV Technologies, personal fees from Aimmune Therapeutics, personal fees from Duke Clinical Research Institute, personal fees from Ukko, other from Bellhaven Biopharma, personal fees from Kenota Health, personal fees from AllerGenis, personal fees from ALK, personal fees from Allakos, personal fees from Nutricia, grants from FARE, and grants from Wallace Research Foundation, outside the submitted work.

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Francis, O., Kim, E.H. Peanut Immunotherapy: Practical Applications. Curr Treat Options Allergy 8, 242–260 (2021). https://doi.org/10.1007/s40521-021-00292-0

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