A new OIT protocol for severe peanut allergy

Methods Our pirmary outcome was the increase in the amount of ingested peanut protein tolerated in DBPCFC by peanut OIT. Secondarily we investigated safety of OIT. Since September 2011, peanut-sensitized patients with moderate to severe allergic reaction (1) in DBPCFC were included. Bronchial hyperreactivity, exhaled nitric oxide, and food allergy related quality of life (2, 3) were evaluated pre and post OIT. Roasted and defatted peanut flour, allergenity of which was assessed using microarray inhibition, was mixed with margarine (no milk or soy) in 3 concentrations at hospital kitchen. A teaspoonful of peanut-margarine mixture weight 1.7 g. From week 20 and on, we used real peanuts. The first dose of 0.1 mg peanut protein was taken at hospital and the same dose continued daily at home. Dose escalations occurred at home every 1 to 2 weeks. The patient returned to the hospital 7 times for dose escalation. Antihistamine was taken daily until 2 weeks from reaching the maintenance dose of 4 peanuts. As safety procedures, exercise was forbidden one hour post each dose and the day of escalation, and the patients carried adrenalin auto-injectors.