New study shows sublingual immunotherapy is effective in young children with peanut allergy

Low doses of peanut taken under the tongue have been shown to improve tolerance of peanuts in young children. Researchers in the US have completed a trial examining the safety and efficacy of sublingual immunotherapy and found it has potential for long lasting effects and is most effective in young children.

Immunotherapy aims to desensitise the immune system to the food a person is allergic to so they’re less likely to have a reaction. It does this by gradually exposing them to small amounts of that food, building up the amounts over the weeks and months. In this study a small amount of peanut protein was given under the tongue. This is known as sublingual immunotherapy (SLIT).

In this three-year placebo-controlled trial, 50 children aged one to four were given 4mg of peanut under the tongue or a placebo (dummy treatment) daily for three years. At the end of which, they were given a food challenge where they ate a small amount of peanut protein under supervision to test for desensitisation.

60% of those given the peanut treatment passed the food challenge compared to 0% of those receiving a placebo, and those in the peanut group were able to tolerate and average of 4443 mg of peanut protein compared to 143mg in the placebo group. Those who could tolerate at least 443 mg peanut protein had another food challenge three months later to test for remission – 48% of those in the peanut group passed the challenge, showing the treatment was still effective three months later.

The treatment was most effective in younger children. The highest rate of desensitization and remission was seen in one- to two-year-olds, followed by two- to three-year-olds and three- to four-year-olds.

The researchers said this is the first trial to demonstrate the safety and efficacy of low-dose SLIT for peanut allergies in young children. The results suggest a window of opportunity for treatment while children are very young.

Larger trials are needed but the results suggest treatment at a very young age could have lasting benefits.

Read the full paper in The Journal of Allergy and Clinical Immunology

Read more about immunotherapy