Table 1A.
Study | Food allergen | N | Age Range | Study design | Maintenance Dose | Desensitization Outcome | Long-term results | Adverse events |
---|---|---|---|---|---|---|---|---|
Hofmann et al. 200962 Jones et al. 200946 |
Peanut | 39 | 1–16 years | Open-label, not controlled. | 300–1800 mg | 71% reached 300 mg daily dose. | 69% (27/39) passed OFC at 1800 mg (total 3.9 g). | Escalation: 92% symptomatic, 15% needed epinephrine. 3.7 % of 14,773 doses during up-dosing or maintenance, mostly minor. |
Blumchen et al. 201047 | Peanut | 23 | 3–14 years | Open label, not controlled. | ?500 mg | 61% (14/23) reached 500 mg daily for 8 weeks. | After 2 weeks off OIT, 14/23 (100% who reached maintenance) tolerated 500 mg in DBPCFC, 17% tolerated 4 g. | Escalation: subjective symptoms with 25/317 (7.9 %) doses. Reactions with 160/6137 (2.6 %) of buildup/maintenance doses. |
Varshney et al. 201148 | Peanut | 28 (2:1 OIT: placebo) | 1–16 years | RCT, placebo-controlled, double-blind. | Up to 4000 mg daily | 80% on OIT tolerated 4000 mg daily for 1 year, 80% on OIT passed 5000 mg DBPCFC after 1 year. | N/A | Escalation: 47% (9/19) of OIT had symptoms, 2 required epinephrine. Reactions with 1.2 % of buildup/maintenance doses. |
Vickery et al. 201433 | Peanut | 39 | 1–16 years | Open label, not controlled (enrolled patients from53 and24). | 300 mg OR 1800 mg (if passed 3900mg OFC), then 4000 mg daily | 66% (26/39) reached 4000 mg daily. | After 4 weeks off OIT, 31% (12/39) tolerated 5000 mg OFC and open dose. | 15% withdrew for allergic side effects. |
Anagnostou et al. 201463 | Peanut | 99 | 7–16 years | RCT, placebo-controlled, double-blind. (OIT/placebo), control group crossed over to active OIT. | 800 mg | Phase 1: 84% OIT, 0 % placebo passed 1400 mg DBPCFC. Phase 2: placebo patients switched to OIT, 54% passed the same DBPCFC. | Phase 1: 62% OIT, 0 % placebo tolerated 800 mg daily at 26 weeks. Phase 2: placebo patients switched to OIT, 91% tolerated 800 mg daily at 26 weeks. QoL improved in both groups. | Up-dosing: Mild adverse events in 6.3 % of doses. 1 patient received epinephrine for 2 separate reactions. |
Narisety et al. 201532 | Peanut | 21 | 7–13 years | RCT, parallel intervention, double blind (1:1 OIT/SLIT). | 2000 mg OIT, 3.7 mg SLIT | 50% SLIT, 45% OIT passed OFC 10g at 6–12 months. | Sustained unresponsiveness: 50% (2/4) OIT, 20% (1/5) SLIT passed repeat OFC 10 g after 4 weeks peanut avoidance. | Reactions to 43% of OIT, 9 % of SLIT. 5 OIT reactions required epinephrine. 1 OIT patient developed eosinophilic esophagitis and withdrew. |
Syed et al. 201428 | Peanut | 43 | 5–45 years | RCT, open label (OIT/peanut avoidance). | 4000 mg | 20/23 OIT, 0 % (0/20) control desensitized (passed DBPCFC 4 g) at 24 months. | Sustained unresponsiveness: after off peanut OIT for 3 months, 30% (7/23) passed DBPCFC at 27 months. After off peanut for 6 months, 13% (3/7 SU, 3/23 ITT) remained tolerant (passed DBPCFC). | N/A |
Tang et al. 201545 | Peanut and lactobacillus | 62 | 1–10 years | RCT, placebo controlled, double blind (Probiotic?+?OIT vs. placebo?+?placebo OIT). | 2000 mg | 90% probiotic?+?OIT, 7 % placebo desensitized (DBPCFC). | Sustained unresponsiveness: 82% probiotic, 4 % placebo (DBPCFC 2–5 weeks after probiotic discontinued). | 45% probiotic, 32% placebo patients had ?1 severe adverse event. 1 patient had anaphylaxis to probiotic. |