Introduction

In 2020, the US Food and Drug Administration approved the first oral immunotherapy Peanut (Arachis hypogaea) Allergen Powder-dnfp (PTAH) for the mitigation of allergic reactions to peanut. Treatment involves an initial dose escalation appointment followed by ‘up-dosing' appointments at ≥2-week intervals for approximately 6 months. Daily dosing at home is required, and patients remain on long-term daily maintenance treatment. This study sought to understand patient and caregiver experiences of treatment in a real-world setting.

Methods

Semi-structured qualitative interviews were conducted with patients (8-17 years at treatment initiation) and caregivers of patients (4-17 years at treatment initiation). Interviews were conducted via teleconference, recorded, transcribed verbatim, and analysed using content and thematic analysis. Participants provided informed consent; the study received ethical approval from WCG Institutional Review Board.

Results

13 patients and 14 caregivers at varying treatment phases (initial dose escalation, up-dosing, maintenance) participated. Experiences were characterised by four themes: 1. Preparing for treatment (e.g., information seeking), 2. Treatment in the clinic (e.g., scheduling, attending appointments), 3. Home-dosing (e.g., treatment restrictions, changes to routines), 4. Methods to successfully integrate treatment into daily lives (e.g., managing taste, establishing new routines). Despite these considerations, many participants described how actual and anticipated treatment benefits outweighed the potential burden.

Conclusion

Findings characterize the experience of PTAH in a real-world setting, and the benefits appear to mitigate challenges that arise from the treatment. The experiences described in this research may benefit those considering treatment by providing practical and logistical solutions for integration of treatment into daily life.