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Advances in the management of peanut allergy (oral immunotherapy and epicutaneous immunotherapy)

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Peanut allergy affects up to 2% of the general population and carries not only the risk of potentially life-threatening allergic reactions but also negatively impacts day to day life for patients and their families. Advances in knowledge in immunotherapy is providing families with options for proactive treatment.


To examine the available data for oral immunotherapy (OIT) and epicutaneous immunotherapy (EPIT) for peanut allergy.


This review discusses recent studies that evaluated the safety and efficacy of OIT and EPIT to induce desensitization to peanut and identifies factors that should be considered when guiding families in treatment decisions.


Results of studies have demonstrated that immunotherapy can raise the threshold of peanut allergen to induce allergic reactions for many patients, thereby potentially reducing the risk for allergic reactions and decreasing the daily burden of peanut allergy. However, adverse reactions, which range from mild to severe, are possible with immunotherapy. Shared decision-making will be important to determine the best approach for peanut allergy management for each individual and his or her family.


OIT and EPIT will offer patients and families more options for managing peanut allergies. Recent data from phase III studies on OIT and EPIT as well as real-world data on OIT advance the understanding of the efficacy and safety of these approaches. On-going studies aim to identify biomarkers to enhance patient selection criteria as well as develop additional therapeutic approaches.
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Keywords: anaphylaxis; desensitization; epicutaneous immunotherapy; food allergy; oral immunotherapy; peanut; treatment

Document Type: Research Article

Publication date: January 1, 2020

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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