Evidence map›Paper›PMID 40760836›Full record

Trial reportClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology2025

Pragmatic Low-Dose Oral Immunotherapy for Preschool Children With Peanut Allergy: A Randomised Controlled Trial.

Michael O'Sullivan, Rachael Wallace, Samantha Thomas, Alyssa Godfrey, Natasha Bear, Bhaumik Mevavala, Sarah Miller, Ingrid Roche, Samara Baldwin, Jessica R Metcalfe

Abstract readRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Hazelnut oral immunotherapy in children: An Italian single-center retrospective cohort study.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Michael O'SullivanImmunology Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.ORCID https://orcid.org/0000-0001-7896-2697
Rachael WallaceImmunology Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.
Samantha ThomasImmunology Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.
Alyssa GodfreyImmunology Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.
Natasha BearImmunology Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.
Bhaumik MevavalaImmunology Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.
Sarah MillerThe Kids Research Institute Australia, Nedlands, Western Australia, Australia.
Ingrid RocheAdvanced Dietitians Group, Leederville, Western Australia, Australia.
Samara BaldwinImmunology Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.
Jessica R MetcalfeImmunology Department, Perth Children's Hospital, Nedlands, Western Australia, Australia.

Funding

Department of Health, Government of Western Australia
6 · The paper itself

Abstract

introductionPeanut allergy is the most common childhood-onset, persistent food allergy. Peanut oral immunotherapy (OIT) is a potential treatment, but few studies prospectively examine the outcome of peanut OIT in young children using parent-measured doses compared to standard care (peanut avoidance).

objectiveTo determine the efficacy, safety and tolerability of a pragmatic peanut OIT protocol (parent-measured doses with low maintenance dose) compared to avoidance.

methodsIn this unblinded randomised controlled trial (1:1 ratio), children 1-4 years old were assigned to receive peanut OIT (maintenance dose 360 mg) or avoidance for 12 months. The primary outcome was desensitisation, defined as the ability to tolerate at least 600 mg peanut protein during an end-of-treatment oral food challenge (EOT OFC), with secondary outcomes frequency and severity of adverse events, change in quality of life and change in immunological markers of peanut allergy.

resultsA total of 54 children were randomised, with 23/27 in the peanut OIT and 25/27 in the avoidance group undergoing open peanut challenge after 12 months. An eliciting dose of ≥ 600 mg peanut protein was tolerated by 74% (20/27) of OIT compared to 11% (3/27) of avoidance participants. 41% of OIT (11/27) and 7% of avoidance (2/27) participants passed the end-of-treatment challenge. The OIT group reported significantly better quality of life than the avoidance group after 12 months (Food Allergy Quality of Life Questionnaire-Parent Form mean difference -0.5, p = 0.041). There were 79 treatment-related adverse events reported by 21 participants in the OIT group (median 2 per participant, range 0-13).

conclusionPeanut OIT using parent-measured doses and a low maintenance dose of 360 mg is effective at inducing desensitisation after 12 months in 1- to 4-year-old children. In this cohort, peanut OIT is associated with improved quality of life compared to avoidance and appears to have an acceptable safety profile.

trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12621001001886 (registered 30 July 2021).

Indexed as

AllergensDesensitization, ImmunologicPeanut HypersensitivityAdministration, OralArachisChild, PreschoolFemaleHumansInfantMaleQuality of LifeTreatment OutcomeAllergensoral immunotherapypeanut allergyquality of lifetreatment

Identifiers

PMID40760836
PMCPMC12617499

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.