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AAAAI: Small Amounts of Dietary Peanuts Beneficial After Immunotherapy

THURSDAY, Feb. 28, 2019 -- Most individuals who complete peanut immunotherapy trials continue peanut consumption with few reports of reactions, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology, held from Feb. 22 to 25 in San Francisco.

Quindelyn Cook, M.D., from the University of North Carolina at Chapel Hill, and colleagues conducted a longitudinal observational trial involving 55 participants who completed oral (OIT) or sublingual immunotherapy (SLIT) trials and were desensitized to ≥300 mg of peanut. Peanut food equivalent dosing and associated reactions were reviewed between 2010 and 2017.

Forty-nine participants (89 percent) continued peanut consumption. The researchers found that the median peanut consumed was 600 mg and 31 participants consumed peanut daily. Overall, 23.8 percent of participants reported reactions, most commonly urticaria, gastrointestinal symptoms, and oropharyngeal pruritus. Most of the reactions were treated with antihistamines; one required epinephrine and two required emergency medical services. Compared with OIT participants, SLIT participants consumed less peanut (median, 500 versus 600 mg); more reactions with dosing were reported with OIT.

"People just want to know that they are protected," a coauthor said in a statement. "They don't necessarily want to eat large amounts of their allergen, they just want a level of reassurance that if a restaurant cook makes a mistake or a food label is wrong, they won't have a severe allergic reaction."

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Posted: February 2019

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