TOPLINE

Probiotic peanut oral immunotherapy (PPOIT) and peanut OIT demonstrated lasting benefits 3 years after treatment, with participants in remission having fewer reactions and greater improvements in quality of life.

METHODOLOGY

• Researchers analyzed 3-year posttreatment outcomes in 129 participants (58 in remission, 33 with desensitization without remission [DWR], and 38 with peanut allergy) who completed the PPOIT randomized trial and enrolled in the follow-on study conducted in Australia.
• Participants in the original trial received 18 months of high-dose (2000 mg) PPOIT, standalone high-dose (2000 mg) peanut OIT, or placebo, with end-of-treatment outcomes classified as remission, DWR, or allergy.
• Follow-up occurred yearly at scheduled posttreatment timepoints; peanut consumption and reactions were recorded using a standardized questionnaire and a mobile diary app.
• Researchers assessed peanut ingestion patterns, peanut reactions, and health-related quality of life.

TAKEAWAY

• The proportion of participants in remission who continued to consume peanuts at 3 years post-treatment remained similar to that observed in previous posttreatment years, with 51.9% reporting that they enjoyed peanuts or consumed them frequently; among participants with DWR, 46.7% maintained the recommended daily intake and 26.7% reported difficulty adhering to daily intake.
• Participants in remission had greater improvements in health-related quality of life from baseline than participants with DWR (mean difference [MD], -0.67; P = .006) and those with allergy (MD, -1.29; P < .001).
• Participants in remission did not have any moderate or severe reactions; however, those with DWR and those with allergy had moderate and severe reactions, with rescue adrenaline used in 6.1% and 7.9% of participants, respectively.
• Improvement in quality of life was significantly greater in participants in remission than in those with DWR and allergy; participants with DWR showed a meaningful quality-of-life benefit over those with allergy for the first time at the 3-year mark.

IN PRACTICE

“Remission participants were able to eat peanut without limitation, which translated to substantial and lasting improvements in HRQOL [health-related quality of life], beyond the benefits conferred by desensitization alone,” the authors wrote.

SOURCE

Mimi L.K. Tang, MD, with the Murdoch Children’s Research Institute, Parkville, Australia, was the corresponding author of the study, which was published online on July 21 in Allergy.

LIMITATIONS

Adherence to daily peanut ingestion among participants with DWR was not formally assessed, but declining adherence may explain the higher reaction rates observed in this group. Subgroup sizes, particularly for comparisons of reaction severity, were small.

DISCLOSURES

This study was supported by the Murdoch Children’s Research Institute. Some authors, including the lead author, reported receiving consultant fees or research grants from various pharmaceutical companies, including Prota Therapeutics. The corresponding author reported holding patents related to PPOIT and peanut OIT and having share interests in Prota Therapeutics. Detailed disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.