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Oral immunotherapy induces remission of peanut allergy in some young children: NIH trial found experimental therapy also reduced most children's sensitivity to peanut:

"The landmark results of the IMPACT trial suggest a window of opportunity in early childhood to induce remission of peanut allergy through oral immunotherapy," said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. "It is our hope that these study findings will inform the development of treatment modalities that reduce the burden of peanut allergy in children." NIAID sponsored the trial and funded it through its Immune Tolerance Network.

Peanut allergy affects about 2% of children in the United States, or nearly 1.5 million individuals ages 17 years and younger. The risk of a life-threatening allergic reaction to accidentally eaten peanut is significant for these children, most of whom remain peanut-allergic for life.

[...] Nearly 150 children ages 1 to 3 years participated in the IMPACT trial at five academic medical centers in the United States. Only children who had an allergic reaction after eating half a gram of peanut protein (about 1.5 peanuts) or less were eligible to join the study. The children were assigned at random to receive either flour containing peanut protein or a placebo flour of similar appearance. The flours were mixed with foods such as applesauce or pudding to help mask their taste. No one except a site pharmacist and a site dietician knew who received peanut flour or placebo flour until all the data were gathered and study visits had ended.

[...] At the end of the treatment period, 71% of children who had received peanut flour were desensitized to peanut, compared to only 2% of those who had received the placebo flour. Desensitization was defined as being able to eat 5 grams of peanut protein during the first oral food challenge without having an allergic reaction. After six months of peanut avoidance following treatment, 21% of children who had received peanut flour could eat 5 grams of peanut protein during the second oral food challenge without having an allergic reaction and therefore were in remission. By contrast, only 2% of children who had received placebo flour were in remission at that time.

More information about the IMPACT trial is available at ClinicalTrials.gov under study identifier NCT01867671 (https://www.clinicaltrials.gov/ct2/show/NCT01867671).

Journal Reference:
Prof Stacie M Jones, MD, Edwin H Kim, MD, Prof Kari C Nadeau, MD, et al. Efficacy and safety of oral immunotherapy in children aged 1–3 years with peanut allergy (the Immune Tolerance Network IMPACT trial): a randomised placebo-controlled study, The Lancet (DOI: 10.1016/S0140-6736(21)02390-4)

Original Submission