A randomized, double-blind, placebo-controlled pilot study of sublingual versus oral immunotherapy for the treatment of peanut allergy

Satya D. Narisety, Pamela A. Frischmeyer-Guerrerio, Corinne Keet, Mark Gorelik, John Thomas Schroeder, Robert G Hamilton, Robert A Wood

Research output: Contribution to journalArticle

Abstract

Background Although promising results have emerged regarding oral immunotherapy (OIT) and sublingual immunotherapy (SLIT) for the treatment of peanut allergy (PA), direct comparisons of these approaches are limited. Objective This study was conducted to compare the safety, efficacy, and mechanistic correlates of peanut OIT and SLIT. Methods In this double-blind study children with PA were randomized to receive active SLIT/placebo OIT or active OIT/placebo SLIT. Doses were escalated to 3.7 mg/d (SLIT) or 2000 mg/d (OIT), and subjects were rechallenged after 6 and 12 months of maintenance. After unblinding, therapy was modified per protocol to offer an additional 6 months of therapy. Subjects who passed challenges at 12 or 18 months were taken off treatment for 4 weeks and rechallenged. Results Twenty-one subjects aged 7 to 13 years were randomized. Five discontinued therapy during the blinded phase. Of the remaining 16, all had a greater than 10-fold increase in challenge threshold after 12 months. The increased threshold was significantly greater in the active OIT group (141- vs 22-fold, P =.01). Significant within-group changes in skin test results and peanut-specific IgE and IgG4 levels were found, with overall greater effects with OIT. Adverse reactions were generally mild but more common with OIT (P

Original languageEnglish (US)
Pages (from-to)1275-1286e6
JournalThe Journal of Allergy and Clinical Immunology
Volume135
Issue number5
DOIs
StatePublished - May 1 2015

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Peanut Hypersensitivity
Sublingual Immunotherapy
Immunotherapy
Placebos
Active Immunotherapy
Therapeutics
Skin Tests
Double-Blind Method
Immunoglobulin E
Immunoglobulin G
Maintenance
Safety

Keywords

  • food allergy
  • immunotherapy
  • oral immunotherapy
  • Peanut allergy
  • sublingual immunotherapy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

A randomized, double-blind, placebo-controlled pilot study of sublingual versus oral immunotherapy for the treatment of peanut allergy. / Narisety, Satya D.; Frischmeyer-Guerrerio, Pamela A.; Keet, Corinne; Gorelik, Mark; Schroeder, John Thomas; Hamilton, Robert G; Wood, Robert A.

In: The Journal of Allergy and Clinical Immunology, Vol. 135, No. 5, 01.05.2015, p. 1275-1286e6.

Research output: Contribution to journalArticle

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