Five Year Follow-Up of Early Intervention Peanut OIT Showed Characteristics of Sustained and Prolonged Clinical Benefit

Long-term outcome data following oral immunotherapy (OIT) are sparse. We previously showed high rates of sustained unresponsiveness with early-intervention peanut OIT in preschool children, and report here the first follow-up data from a longitudinal post-treatment study. Caregivers of all 32 participants completing the parent trial were invited to complete a follow-up phone survey assessing the following domains associated with peanut consumption: Quantity, frequency, tolerability, safety, and lifestyle impact. Survey response rate was 75% (n=24). Mean follow-up interval was 62 months. Twenty-three subjects (96%) continue peanut consumption, including 92% who ignore precautionary labels. Twenty-two (92%) reported no allergic symptoms following ingestion; 2 (8%) reported transient mild symptoms. One subject (4%) with multiple food allergies stopped consuming peanut two years after study completion due to diagnosed eosinophilic esophagitis. Reported per-serving consumption of peanut protein (mg) was: >1000 (58%); 600-1000 (17%); 300 (17%); 100 (4%); 0 (4%). Reported frequency of consumption was: 5-7 days/week (54%); 1-4 days/week (33%); few times/month (8%); avoidance (4%). Parents of 20 participants reported feelings of increased safety and have relaxed restrictions on child activities away from home. Parents of 22 participants reported overall improvement in lifestyle quality for themselves and child. Sixteen (67%) do not see an allergist regularly. Of these, 8 (33%) had only peanut allergy and no longer carry epinephrine auto-injectors. Five years after early-intervention OIT, most caregivers reported improved lifestyles and safe and well-tolerated consumption of peanut. Some participants developed features suggesting sustained and prolonged clinical benefit from peanut OIT. Further follow-up is needed.