A New Study Shows How Effective A Simple Treatment Can Be For Mild Peanut Allergies

A peanut allergy is no fun, especially for kids — not only are you deprived of one of life’s greatest joys, a peanut butter and jelly sandwich (cut in triangles with no crust), but you can also be at real risk for serious reaction and injury if accidentally exposed.

Well, a PB&J might actually be in the cards for some allergy sufferers. A report published just this week in NEJM Evidence has found that children with milder peanut allergies were able to curb their reaction by consuming increasing amounts of peanut butter — a process known as oral immunotherapy.

“Oral immunotherapy (OIT) is fairly straightforward,” Dr. Zoya Treyster, a board-certified allergist and immunologist at Latitude Food Allergy Care told Scary Mommy. “On the first appointment, we have the patients eat 2 to 3 teeny tiny ‘doses’ of their allergens in flour form mixed with applesauce or yogurt under medical supervision.”

She explained that the patient then goes home, and eats the same amount of the allergen for a period of time, returning to up their consumption until they are able to tolerate a full dosage.

The new study consisted of participants between the ages of 4 and 14 with mild peanut allergies (in the case of this study, those who were able to ingest more than 143 mg of peanut protein, but less than 5043 mg without experiencing a reaction). 38 participants were randomly assigned to practice peanut OIT, while 32 participants avoided peanuts all together.

Participants in the OIT group started by consuming one eighth of a teaspoon of peanut butter under the researchers’ supervision, returning every eight weeks to test their tolerance of increasing amounts. If the participant didn’t experience an allergic reaction, they practiced at home, consuming the equivalent amount of store-bought peanut butter every day.

At 72 weeks — 8 weeks after the participants reached one tablespoon of peanut butter — tolerance was tested again for both the OIT group and the avoidance group. The OIT participants who tolerated that dose continued on to consume two tablespoons of peanut butter for 16 weeks, and then avoid it entirely for eight weeks, to determine if their tolerance was sustained.

At the end of the study, 100% of the participants who completed the full course of OIT tolerated a full dose, 9043 mg (nearly 3 tablespoons) of peanut butter — this included 30 of the original 38 participants assigned to the group, as some withdrew for personal reasons or were excluded for not adhering to the instructions. Of the group that avoided peanut butter all together, only 3 tolerated the final dose, which the researchers attributed to “naturally occurring tolerance.”

The results are unsurprising to OIT practitioners like Dr. Treyster, who attests that her clinic success rate is 92% for patients with even the most severe allergies, and reaches 97% for patients under 4.

Even with such a high success rate, OIT might sound a bit frightening to parents of children with allergies, but Dr. Treyster assured parents that it is a safe and effective option.

“It is totally normal to be nervous about having your child eat a food that they have been avoiding and fearing potentially for years,” she said. “Of course, there is a risk of reactions with OIT. However, the vast majority of reactions are mild and easily treated. It is rare for our patients to experience a severe reaction.”

Dr. Treyster recommended parents connect with other families who have undergone OIT through online groups or food allergy communities, and emphasized the importance of finding a provider with expertise.

“There is a lot of misinformation about OIT out there, even among general allergists and pediatricians. So, it’s important to talk to a provider that is experienced in OIT.”