Long-term clinical and immunological effects of probiotic and peanut oral immunotherapy after treatment cessation: 4-year follow-up of a randomised, double-blind, placebo-controlled trial

This analysis of 48/56 patients who completed a placebo-controlled trial of combined probiotic and peanut oral immunotherapy suggests it provides long-lasting suppression of peanut allergy, with patients randomised to treatment more likely to have continued eating peanut products

After a median of 4.2 years since finishing study treatment, two thirds (16 of 24) of children who were randomised to receive PPOIT had continued to eat peanuts regularly, but only one child in the placebo group did (absolute difference 63% (95% confidence interval 42 to 83); P=0.001). This gave a number needed to treat of 1.6 (95% confidence interval 1.2 to 2.4). Four of the children who were given active treatment and six in the placebo group reported allergic reactions to peanut after intentional or accidental intake since stopping treatment, but none had anaphylaxis. Children who were given the active treatment also showed sustained unresponsiveness to peanut food challenges and persistent suppression of the allergic immune response to peanut.

 

The authors say their findings are a step towards identification of an effective treatment for food allergy and that tolerance may be a realistic target of such treatments.