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Allergen specific IgE is a stronger predictor of remission following Peanut Oral Immunotherapy than age in children aged 1-10 years
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  • Sarah Ashley,
  • Melanie Lloyd,
  • Paxton Loke,
  • Francesca Orsini,
  • Adriana Chebar Lozinsky Rolnik,
  • Michael O'Sullivan,
  • Patrick Quinn,
  • Michael Gold,
  • Mimi Tang
Sarah Ashley
Murdoch Children's Research Institute
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Melanie Lloyd
Murdoch Children's Research Institute
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Paxton Loke
Murdoch Children's Research Institute
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Francesca Orsini
Murdoch Children's Research Institute
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Adriana Chebar Lozinsky Rolnik
Murdoch Children's Research Institute
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Michael O'Sullivan
Telethon Kids Institute
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Patrick Quinn
The University of Adelaide
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Michael Gold
The University of Adelaide
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Mimi Tang
Murdoch Children's Research Institute

Corresponding Author:[email protected]

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Abstract

Remission is the desired outcome following OIT as it allows individuals to discontinue treatment and eat the allergen freely. Early initiation of OIT in infants and toddlers has been embraced as an approach to increase the likelihood of remission. However, there is no high-quality evidence supporting younger age as an independent factor driving remission; available studies are limited by small samples of younger subjects and lack of adjustment for confounding covariates, particularly peanut-specific IgE (sIgE) levels which is closely correlated with age. This study examined relationships between peanut sIgE and age at baseline and remission, in children aged 1-10 who completed 18 months of OIT in the PPOIT-003 RCT (n=162). Remission was defined as absence of clinical reactivity to peanut after 8 weeks of allergen avoidance/treatment discontinuation. Age and sIgE were examined as continuous variables in univariate and multivariate regression models. Baseline peanut sIgE levels were significantly associated with remission, independent of age (OR 0.1 [0.05-0.22], p<0.001). Higher peanut sIgE was consistently predictive of lower likelihood of remission, independent of age. In contrast, there was no independent association between age and remission after adjusting for baseline sIgE (OR 0.94 [0.79-1.12], p=0.5). Findings do not support age as an independent predictor of remission following OIT. Additional studies examining safety and efficacy of OIT in infants and younger children are urgently needed, ahead of widespread adoption of early intervention.
08 Aug 2024Submitted to Allergy
17 Aug 2024Submission Checks Completed
17 Aug 2024Assigned to Editor
17 Aug 2024Review(s) Completed, Editorial Evaluation Pending
23 Aug 2024Reviewer(s) Assigned
19 Sep 2024Editorial Decision: Revise Minor
30 Oct 20241st Revision Received
01 Nov 2024Submission Checks Completed
01 Nov 2024Assigned to Editor
01 Nov 2024Review(s) Completed, Editorial Evaluation Pending
03 Nov 2024Reviewer(s) Assigned