Sustained outcomes in oral immunotherapy for peanut allergy (POISED study): a large, randomised, double-blind, placebo-controlled, phase 2 study

Chinthrajah, R. Sharon; Purington, Natasha; Andorf, Sandra; Long, Andrew J.; O'Laughlin, Katherine; Lyu, Shu Chen; Manohar, Monali; Boyd, Scott D.; Tibshirani, Robert; Maecker, Holden T.; Plaut, Marshall; Mukai, Kaori; Tsai, Mindy; Desai, Manisha; Galli, Stephen J.; Nadeau, Kari

doi:10.1016/s0140-6736(19)31793-3

Cited by 251 publications

(242 citation statements)

References 34 publications

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“…The POISED study also produced evidence of the responsiveness of OIT and addressed questions of durability of treatment effects and appropriate maintenance doses. 21 For the first time, randomized maintenance doses were investigated and long-term data following OIT were highlighted. Patients who underwent peanut OIT for 2 years were 120.8 times more likely to pass a peanut challenge to 4000 mg protein at 2 years.…”

Section: Efficacymentioning

confidence: 99%

Oral immunotherapy for peanut allergy: The pro argument

Chinthrajah

Cao

Dunham

et al. 2020

World Allergy Organization Journal

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Food allergy (FA) is a growing public health problem with personal, social, nutritional, and economic consequences. In the United States, it is estimated that 8% of children and 10.8% of adults have food allergies. Allergies to peanuts are particularly worrisome as unlike allergies to other allergenic foods, such as milk and egg, which are commonly outgrown by 5 or 10 years of age, 80% of peanut allergies persist into adulthood. The first drug for peanut allergy, Palforzia, was approved by the US Food and Drug Administration (FDA) in January 2020. For other food allergies, the current standard of care for the management of FA is suboptimal and is limited to dietary elimination of the offending allergen, vigilance against accidental ingestion, and treatment of allergic reactions with antihistamines and epinephrine. However, dietary avoidance can be challenging, and it is estimated that approximately 40% of patients with food allergies report at least one food allergy-related emergency department in their lifetime. Reactions, even from minimal exposures, can be life-threatening. Oral immunotherapy (OIT) has been the best researched therapeutic approach for treating FA over the last decade, with clinical trials investigating its efficacy, safety, and ability to improve participants' quality of life (QoL). A number of studies and meta-analyses have shown that OIT treatment is effective in raising the threshold of reactivity to peanuts and other foods in addition to producing a measurable serum immune response to such therapy. Although OIT-related adverse events (AEs) are common during treatment, serious reactions are rare. In fact, while the majority of patients experience AEs related to dosing, most continue daily dosing in hopes of achieving protection against the culprit food. Moreover, the majority of participants report improvement of QoL after OIT and are positive about undergoing OIT. These results show patients' commitment to OIT and their optimism regarding the benefits of treatment. As a first step in therapeutic options to protect from reactions to unintentional ingestion of allergenic foods, and importantly, to address the many psychosocial aspects of living with FA, OIT shows promise. Future research will focus on identifying optimal OIT regimens that maintain protection after therapy and allow for regular food consumption without allergic symptoms. Education and informed shared decision making between patients and providers are essential in optimizing current therapy regimens.

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Section: Efficacymentioning

confidence: 99%

Oral immunotherapy for peanut allergy: The pro argument

Chinthrajah

Cao

Dunham

et al. 2020

World Allergy Organization Journal

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“…Peanut allergy was determined by validated food challenge performed in our clinical research unit with trained personnel as per PRACTALL guidelines, and they all reacted at 144 mg dose with hives. 11 Due to the summer-fall seasons (2019) in which the infants were treated during the 12-week period, they were likely not exposed frequently to grass pollens. Tables 1 and 2 outline the baseline characteristics of infants by treatment group and atopic status, respectively.…”

Section: Increases In Plasma Igg4/ige With Trilipid Vs Paraffin/ Petrmentioning

confidence: 99%

Increases in plasma IgG4/IgE with trilipid vs paraffin/petrolatum‐based emollients for dry skin/eczema

Sindher

Alkotob

Shojinaga

et al. 2020

Pediatric Allergy Immunology

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“…Diese Therapie hat ebenfalls den Nachteil, sehr nebenwirkungsreich zu sein. Außerdem scheint kein langfristiger immunologischer Effekt erreicht zu werden, sodass der Toleranzeffekt mit dem Tag des Absetzens sehr rasch wieder verschwindet [ 16 ]. Ein europäisches Zentrum mit hoher Kompetenz zu diesem Thema ist an der Pädiatrie der Charité in Berlin beheimatet, wo aber auch nur sehr wenige Kleinkinder mit hohem Risikoprofil solch einem Verfahren unter stationären Bedingungen unterzogen werden [ 17 ].…”

Section: Anderes In Kürzeunclassified

Allergenspezifische Immuntherapie (AIT) in Österreich

Wöhrl

2020

hautnah

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Die allergenspezifische Immuntherapie (AIT) ist die einzige ursächliche Behandlung der IgE-vermittelten, Typ‑1 allergischen Erkrankungen allergischer Rhinokonjunktivitis, allergischem Asthma bronchiale und anaphylaktischen Reaktionen auf Insektengift („venom immunotherapy“, VIT). Sie wird entweder subkutan (SCIT) oder sublingual (SLIT) über 3 Jahre verbreicht. Da die deutschsprachigen Leitlinien zur AIT sowohl gegen inhalative Allergien als auch die VIT gegen Bienen‑/Wespenallergie abgelaufen und Ende 2020 im Status der Überarbeitung sind, werden sich die Empfehlungen stattdessen auf die europäischen EAACI-Leitlinien von 2018 beziehen.

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Sustained outcomes in oral immunotherapy for peanut allergy (POISED study): a large, randomised, double-blind, placebo-controlled, phase 2 study

Cited by 251 publications

References 34 publications

Oral immunotherapy for peanut allergy: The pro argument

Oral immunotherapy for peanut allergy: The pro argument

Increases in plasma IgG4/IgE with trilipid vs paraffin/petrolatum‐based emollients for dry skin/eczema

Allergenspezifische Immuntherapie (AIT) in Österreich

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