A new review published in the Lancet suggests current oral immunotherapy treatments for peanut allergy may result in a large increase in anaphylaxis and other allergic reactions.
Researchers examined data from 12 studies with more than 1,000 patients and compared the efficacy and safety of oral immunotherapy versus allergen avoidance or placebo for peanut allergy.
They found that while current oral immunotherapy regimens achieved immunological desensitisation, compared with no oral immunotherapy, peanut oral immunotherapy increased anaphylaxis risk (risk ratio [RR] 3.12; 95% CI 1.76-5.55; I2=0%; risk difference [RD] 15.1%; high certainty), frequency (incidence rate ratio [IRR] 2.72; 95% CI 1.57-4.72; I2=0%; RD 12.2%; high certainty) and epinephrine use (RR 2.21; 95% CI 1.27-3.83; I2=0%; RD 4.5%; high certainty). Serious adverse events and non-anaphylactic reactions also increased. There was no difference in quality of life between the groups.
“Considering the current view of peanut allergy oral immunotherapy as a model for other food allergies, and the increasing global prevalence of food allergies, these findings are significant and important to the ongoing development of food allergy treatments,” said lead author Dr Derek Chu, McMaster University, Canada.