Safety and Clinical Outcomes of High‐ Versus Low‐Dose Oral Peanut Immunotherapy in Polish Children With Peanut Allergy
Klementyna Łyżwa, Magdalena Chojnowska‐Wójtowicz, Wioletta Zagórska, Marek Kulus, Katarzyna GrzelaABSTRACT
Aim
To compare safety and clinical outcomes of two different oral immunotherapy (OIT) maintenance doses (150 mg vs. 300 mg) of peanut protein in children with peanut allergy.
Methods
This prospective study enrolled 44 children aged 4–17 years with confirmed peanut allergy. Following dose escalation, participants were allocated to receive either 150 or 300 mg of peanut protein daily for 8 weeks. Oral food challenges (OFCs) were conducted before and after OIT. The primary endpoint was the proportion of participants tolerating ≥ 300 mg of peanut protein post‐treatment. Secondary outcomes included changes in immunologic markers (skin prick tests wheal size, sIgE, IgG4) and safety.
Results
Of the 44 enrolled children, 33 (75.0%) completed the full protocol. The primary outcome was achieved in 73.9% of the 150 mg group and 71.4% of the 300 mg group ( p = 0.853). Both regimens were associated with reductions in immunological parameters. Adverse events were mainly mild to moderate.
Conclusion
Peanut OIT using either 150 mg or 300 mg maintenance doses was associated with increased tolerance thresholds and immunological changes in highly allergic children. These findings support the feasibility of OIT in real‐world clinical settings while highlighting the need for further multicentre research to determine optimal dosing strategies.