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<p class="publishdate"><span property="dc:date" datatype="xsd:dateTime" content="2025-02-25T00:00:00-05:00" class="date-display-single">February 25, 2025</span></p><div class='syndicate'><h1>Therapy boosts peanut tolerance in allergic kids</h1><div class="callout callout-with-border"><h3>At a Glance</h3>
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<ul>
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<li>Peanut-allergic children who could tolerate eating at least a half peanut greatly boosted their tolerance by eating gradually increased daily doses of peanut butter.</li>
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<li>The simple and inexpensive treatment approach could fill an unmet need for the many kids who have a milder “high-threshold” type of peanut allergy.</li>
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</ul></div><div class="media-float-right"><div class="ds-1col file file-image file-image-jpeg view-mode-floated_media clearfix">
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<picture title="A small amount of peanut butter on a knife.">
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-large/public/news-events/research-matters/2025/2025025-peanut.jpg?itok=jMO_N5f4&timestamp=1740424140 1x" media="screen and (min-width: 960px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2025/2025025-peanut.jpg?itok=1L9xLTpw&timestamp=1740424140 1x" media="screen and (min-width: 800px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium-small/public/news-events/research-matters/2025/2025025-peanut.jpg?itok=OOJT6Clw&timestamp=1740424140 1x" media="screen and (min-width: 600px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-small/public/news-events/research-matters/2025/2025025-peanut.jpg?itok=2RWC86dO&timestamp=1740424140 1x" media="screen and (min-width: 480px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-tiny/public/news-events/research-matters/2025/2025025-peanut.jpg?itok=aYp210cq&timestamp=1740424140 1x" media="screen and (min-width: 0)" />
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<!--[if IE 9]></video><![endif]-->
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<img src="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2025/2025025-peanut.jpg?itok=1L9xLTpw&timestamp=1740424140" alt="A small amount of peanut butter on a knife." title="A small amount of peanut butter on a knife." />
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</picture><span class="caption">Researchers tested whether a simple strategy could help kids with high-threshold peanut allergy tolerate more peanut protein. </span><span class="credit">Zoeytoja / Shutterstock </span></div>
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</div><p>Peanut is one of the most common food allergies. It often begins in childhood and usually lasts for life. NIH-supported studies over the past few decades have led to important advances and improved treatment options for many people with peanut allergies. Most such treatments were tested in kids who are highly sensitive to peanuts, unable to tolerate even the equivalent of a half peanut. These treatments can raise the safe threshold before a reaction, but peanut avoidance is still advised.</p>
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||
<p>Less has been known about effective treatments for the estimated 800,000 children in the U.S. who have “high-threshold” peanut allergy. These children can tolerate eating half a peanut or more.</p>
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||
<p>A research team led by Drs. Scott H. Sicherer and Julie Wang of the Icahn School of Medicine at Mount Sinai designed a clinical trial, funded by NIH, to assess whether a simple, low-cost, at-home treatment strategy could help kids with high-threshold peanut allergy tolerate more peanut protein. The study included 73 children, ages 4 to 14 years. They were randomly assigned to either test the new treatment strategy or continue avoiding peanut.</p>
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<p>At the start, children in the treatment group received a minimum daily dose of 1/8 teaspoon of store-bought peanut butter. Doses were gradually increased and tested under medical supervision every eight weeks, followed by at-home dosing. By 8 to 17 months, daily doses had reached about the equivalent of 1 tablespoon of peanut butter.</p>
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<p>Finally, participants in both the treatment and avoidance groups underwent a medically supervised feeding test to assess how much peanut they could eat without an allergic reaction. Results appeared on February 10, 2025, in <em>NEJM Evidence.</em></p>
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<p>The researchers found that all 32 treated children who participated in the oral food challenge could tolerate 9 grams of peanut protein. That’s equivalent to about two and a half tablespoons of peanut butter. By contrast, only three of the 30 kids who underwent the oral food challenge in the avoidance group (10%) could tolerate that much peanut protein.</p>
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<p>The treatment group’s daily at-home doses of peanut butter were well tolerated. None of the treated children needed epinephrine to ease severe allergic reactions at home, although one needed it for a reaction during a medically supervised dose increase.</p>
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<p>To assess the potentially lasting effects of treatment, kids in the treatment group continued to eat at least 2 tablespoons of peanut butter weekly for 16 weeks. They then avoided peanut for eight weeks and returned for a final food challenge. The researchers found that 26 of the 30 treated children (86.7%) were still able to tolerate 9 grams of peanut protein.</p>
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<p>“Our study results suggest a safe, inexpensive, and effective pathway for allergists to treat children with peanut allergy who can already tolerate the equivalent of at least half a peanut, considered a high-threshold peanut allergy,” Sicherer says. “My hope is that this study will eventually change practice to help these children and encourage additional research that includes this approach for more foods.”</p></div><h2 class="label-above">Related Links</h2><ul class="spaced print-urls"><li><a href="https://www.nih.gov/news-events/nih-research-matters/providing-lasting-protection-peanut-allergy" target="_top">Providing Lasting Protection from Peanut Allergy </a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/drug-cuts-risk-allergic-reactions-peanuts-other-foods" target="_top">Drug Cuts Risk of Allergic Reactions to Peanuts and Other Foods </a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/oral-immunotherapy-peanut-allergy-young-children" target="_top">Oral Immunotherapy for Peanut Allergy in Young Children </a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/peanut-allergy-protection-limited-after-oral-immunotherapy" target="_top">Peanut Allergy Protection Limited after Oral Immunotherapy</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/skin-patch-could-treat-peanut-allergy" target="_top">Skin Patch Could Treat Peanut Allergy</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/preschoolers-benefit-peanut-allergy-therapy" target="_top">Preschoolers Benefit from Peanut Allergy Therapy</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/benefits-peanut-allergy-prevention-strategy-persist" target="_top">Benefits of Peanut Allergy Prevention Strategy Persist</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/peanut-consumption-infancy-lowers-peanut-allergy" target="_top">Peanut Consumption in Infancy Lowers Peanut Allergy</a></li><li><a href="https://newsinhealth.nih.gov/2017/03/understanding-food-allergies" target="_top">Understanding Food Allergies: How to Prevent Peanut Allergy and More</a></li><li><a href="https://www.niaid.nih.gov/diseases-conditions/food-allergy" target="_top">Food Allergy</a></li><li><a href="https://www.niaid.nih.gov/sites/default/files/peanut-allergy-prevention-guidelines-parent-summary.pdf" target="_top">Addendum Guidelines for the Prevention of Peanut Allergy in the United States </a></li></ul><p class="footnote"><strong class="label-inline">References: </strong><a href="https://pubmed.ncbi.nlm.nih.gov/39928078/">Peanut Oral Immunotherapy in Children with High-Threshold Peanut Allergy.</a> Sicherer SH, Bunyavanich S, Berin MC, Lo T, Groetch M, Schaible A, Perry SA, Wheatley LM, Fulkerson PC, Chang HL, Suárez-Fariñas M, Sampson HA, Wang J. <em>NEJM Evid. </em>2025 Feb 10:EVIDoa2400306. doi: 10.1056/EVIDoa2400306. Online ahead of print. PMID: 39928078.</p><p class="footnote"><strong class="label-inline">Funding: </strong>NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and National Center for Advancing Translational Sciences (NCATS).</p>
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