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Examining the Use and Outcomes of Peanut Oral Immunotherapy in Peanut-Allergic Children: A Systematic Review of the Literature

Camille Mutukistna, Caoimhe Cronin, Kevin Sheridan, Ciara Tobinb, Juan Trujillo Wurttele

Peanut allergy is one of the most common allergies in children, affecting 1% to 4.5% of the population with a rise in prevalence over the past decade. It is a major public health concern as it significantly diminishes the quality of life of those who are allergic, their families and their caregivers. Peanut allergy is an IgE-mediated Type I hypersensitivity response to peanuts and Peanut Oral Immunotherapy (P-OIT) is a treatment which attempts to mediate this over reactive response to peanuts by repeating and increasing administration of peanut protein doses.

The specific objectives of this review are as follows:

1. To characterize the dosing regimens used for P-OIT in peanut-allergic children.

2. To examine the efficacy and effectiveness of P-OIT in peanut-allergic children.

3. To assess treatment experience of patients during P-OIT in peanut-allergic children.

An electronic search was performed on MEDLINE through EBSCOhost and PubMed databases, yielding 515 articles. After application of filters and duplicate removal, 189 articles remained for screening. After inclusion and exclusion criteria were applied, 36 articles remained. Based on the objectives, 10 articles were selected for this literature review. Which were quantitative in nature and were all valid. Three key themes emerged from the articles. First, by examining the various dosing protocols of P-OIT RCTs (randomised control trials), there is a clear lack of universal recommendations and standardization on up dosing protocols and further research is needed to substantiate standardized dosing regimen recommendations. Secondly, although there is strong evidence for efficacy of the P-OIT RCTs, there is currently no avenue to evaluate whether the P-OIT would be as effective in the community. Finally, there is need for more primary research on the quality of life and treatment experience of participants. As this has shown to be beneficial to facilitating treatment outcomes and will give more insight into alternative methods of increasing the efficacy of P-OIT.