Scoping Review Examining the Effectiveness of Peanut Oral Immunotherapy in Managing Peanut Allergies in Pediatric Populations

Abstract

Background: Peanut allergy is a prevalent food allergy amongst pediatric populations and a leading cause for food-related allergic reactions. Peanut oral immunotherapy is a promising, emerging therapeutic that can be used to initiate desensitization, remission, and tolerance.

Objective: To determine the effectiveness of peanut oral immunotherapy in managing peanut allergies in pediatric populations (defined as birth - 18 years).

Methods: PubMed was searched on December 22nd, 2024, for relevant studies on children published in the last five years. Studies were reviewed in duplicate by two independent reviewers.

Results: Five studies highlighted peanut oral immunotherapy’s positive impact on the management of peanut allergy in children. Chu et al. (2022) found that P-OIT with or without antihistamines induced similar levels of desensitization. Jones et al.’s (2022) data suggest that following peanut oral immunotherapy, 71% of participants achieved desensitization and 21% of participants achieved remission. As per Loke et al. (2022), 46% of children in the PPOIT and 51% of children in the P-OIT group achieved the primary outcome of remission. Furthermore, Loke et al. (2024), found that when P-OIT induces remission, it also has long-term benefits including higher peanut ingestion rates, fewer and less severe reactions, as well as improved HRQL. Uhl et al. (2024) reported an 84% success rate in children for accomplishing peanut protein tolerance for a limit of over 750 mg.

Conclusion: Literature on P-OIT demonstrates effectiveness in desensitization, remission, and tolerance for pediatric PA management. Given the therapeutic novelty, further research is necessary to create a standardized treatment method and confirm the effectiveness of P-OIT in pediatric populations.