Immunoterapia orale per arachide, da piccoli è meglio. I risultati di un RCT

Abstract

Oral immunotherapy for peanut, better as a child; results of an RCT Oral immunotherapy (OIT) in peanut allergy is to date considered experimental, although numerous experiences have documented its protective efficacy to the risk of severe reaction in case of accidental exposure by increasing the tolerance threshold. In some cases, upon discontinuation of treatment it has been possible to maintain this result for a short period. This randomized trial included 146 peanut-allergic children under 4 years of age in a 134-week continued oral immunotherapy treatment. The children underwent double-blind, placebo-controlled triggering test (DBPCFC) at enrollment (cumulative dose up to 500 mg), at week 134 of therapy, and 26 weeks after discontinuation of OIT (cumulative dose up to 5.000 mg). Oral immunotherapy induced desensitization in the majority (71%) of treated children and remission in a smaller part (21%), especially in the youngest ones with lower specific IgE levels at the beginning of treatment. Although most children had dose reactions during OIT, the majority were mild - moderate reactions and adrenaline was given to 21 participants for 35 OIT reactions over 134 weeks at daily dosage.