Early peanut immunotherapy in children (epic) - a pragmatic peanut oral immunotherapy protocol for children under 5 years of age

Michael O'Sullivan, Abigail Hudson, Jessica Metcalfe, Rachael Wallace, Samantha Thomas, Alyssa Godfrey, Jaslyn Ong, Sarah Miller, Ingrid Roche, Lucy Taylor, Ashleigh Kenworthy

Research output: Contribution to journalAbstract/Meeting Abstractpeer-review

Abstract

Introduction: Oral immunotherapy (OIT) is effective at inducing desensitisation in peanut allergic children. OIT is not routinely available in Australia, however food based OIT regimens are used in clinical practice overseas and the peanut OIT product, Palforzia, has been licensed in the US, EU, and UK. A cost-effective, consumer friendly protocol to implement peanut OIT in Australia is needed to provide access to peanut allergy treatment.

Method: Early Peanut Immunotherapy in Children (EPIC) is a pragmatic open label randomised controlled trial establishing the efficacy, safety, and tolerability of 12 months of food-based peanut OIT in children
Results: To date, 42 children have been randomised; n = 22 to OIT; 17 have commenced treatment. Peanut flour doses are measured by parents using measuring spoons with ease. eDiary reporting reveals 17 children have taken a cumulative 1929 doses of peanut OIT at home with 64 parent reported reactions, 42 of which were classified as adverse events including 1 case of anaphylaxis. There are 19 parent reports of OIT-related abdominal pain from five children.

Three children were treated for anaphylaxis during treatment initiation, performed under supervision in hospital. There have been no treatment related Serious Adverse Events.

Conclusion: EPIC seeks to address a need for access to food allergy treatments in Australia by developing a pragmatic, scalable and adaptable protocol. Experience to date supports the feasibility of parent measured OIT dosing and eDiary monitoring. Preliminary safety data demonstrates a low incidence (
Original languageEnglish
Pages (from-to)13-13
Number of pages1
JournalInternal Medicine Journal
Volume52
Issue numberS5
DOIs
Publication statusPublished - Oct 2022

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