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Longer-term SLIT shows promise for peanut allergy

Individuals with peanut allergy experienced moderate levels of desensitization after 3 years of sublingual immunotherapy, according to study results.

“This longer-term study includes assessment of sustained unresponsiveness at year 3 for participants showing desensitization to 10 g of peanut powder,” A. Wesley Burks, MD, of the department of pediatrics at the University of North Carolina, and colleagues wrote. “By study’s end, four participants were fully desensitized … one of whom was not considered a responder at year 2, and all four of whom showed sustained unresponsiveness.”

A. Wesley Burks

The results are the second phase of a previous randomized, double blind, placebo-controlled peanut SLIT trial published in 2013 that reported a favorable safety profile and modest clinical improvement.

In the extended study, 10.8% of participants (n = 37) experienced sustained levels of desensitization to peanut allergy and sustained unresponsiveness at 3 years. They included two participants who received peanut SLIT and two from a high-dose placebo crossover group.

While the number of study participants experiencing desensitization appeared promising, the researchers wrote that 14 of the 40 initial participants withdrew before completion of the third year. This was attributed primarily to failure to maintain daily SLIT dosing.

“More studies will need to evaluate the practical application of SLIT and other proposed daily immunotherapies to address safety and adherence,” the researchers wrote. – by Ryan McDonald

Disclosure: Burks reports board memberships with the American Academy of Allergy, Asthma & Immunology, the Food Allergy Initiative, the Journal of Allergy and Clinical Immunology, the FDA, the National Institutes of Health Study Section grant Review Board, and Food Allergy Research and Education. He reports consultant agreements with Abbott Laboratories, ActoGeniX, Dow AgroSciences, ExploraMed Development, Genentech, McNeill Nutritionals, Merck, Novartis Pharma AG, Nordic Biotech Advisors, Nutricia North America, Perosphere, Perrigo Company, Regeneron Pharmaceuticals, Sanofi U.S. Services, and SRA International. He is employed by Duke University and the University of North Carolina; has received research support from the NIH and Wallace Research Foundation; has provided lectures for Mylan Specialty and Levine’s Children’s Hospital; has received stock from Allertein; is a minority stockholder in Mastcell Pharmaceuticals; has received personal fees from GLG Research; and was a 2012 participant in Orange Ride Associated Universities. See the full study for a list of all the other authors’ relevant financial disclosures.