Expanding real-world access to peanut oral immunotherapy through a US Food and Drug Administrationeapproved approach may be primarily limited by challenges inherent in peanut oral immunotherapy, including time commitment and lifestyle modifications.

A new era of active treatment for food allergy has arrived because patients with peanut allergy are increasingly able to access options for oral immunotherapy (OIT). This milestone is a culmination of years of clinical research and represents a major inflection point for the field because it will have dramatic impacts on allergy practice. In this review, we provide a brief review of the literature as well as practical guidance with concern for the use of U.S. Food and Drug Administration approved peanut OIT as well as shelf-bought products.