Best Science Medicine Podcast - BS without the BS
Aug 26, 2026 · 26 min · 9 segments
In episode 627, Tina and James again invite Danielle Perry and Caitlin Finley back to the podcast to answer the question, in children with peanut allergy, does oral immunotherapy increase peanut…
Danielle PerryGuestJames McCormackHostTina KoronekHost
Caitlin FinleyGuestSo, Danielle, I know you want to give a little bit of a background about really what this question is all about.
So the clinical question that we were trying to answer were in children with peanut allergy, does oral immunotherapy increase peanut tolerance and what are the adverse effects? But I think it's important just to preface this by saying that when we say oral immunotherapy and when we talk about the intervention here, we're not talking about initial exposure to peanuts.
So we actually did a previous tools for practice that looked at peanut introduction.
So talking about, you know, having that initial exposure with your infant and introducing them to allergens.
So when we looked at early peanut introduction, so essentially introducing peanuts somewhere between the ages of three and 10 months, that early introduction was associated with lower peanut allergy risk.
So an allergy developing at about 1.4% of those with the early introduction compared to 4.9% in those who had more of a delayed introduction.
So that early introduction is preventative, but what we're going to be talking about is oral immunotherapy as a therapeutic approach in those children who already have developed a peanut allergy.
So the tricky thing about this evidence is how you actually introduce oral immunotherapy in these kids can differ.
And they were looking at oral immunotherapy compared to placebo or avoidance.
So again, remembering that these are kids with already, they already have an established allergy.
So then you're introducing some sort of this immunotherapy versus, you know, going on and doing what you would do in most situations with an allergy, you'd be avoiding that allergy.
So it's essentially taking like peanut protein and starting kids on like a small amount of this protein and increasing it over time.
So, Danielle, I know you want to give a little bit of a background about really what this question is all about.
So the clinical question that we were trying to answer were in children with peanut allergy, does oral immunotherapy increase peanut tolerance and what are the adverse effects? But I think it's important just to preface this by saying that when we say oral immunotherapy and when we talk about the intervention here, we're not talking about initial exposure to peanuts.
So we actually did a previous tools for practice that looked at peanut introduction.
So talking about, you know, having that initial exposure with your infant and introducing them to allergens.
So when we looked at early peanut introduction, so essentially introducing peanuts somewhere between the ages of three and 10 months, that early introduction was associated with lower peanut allergy risk.
So an allergy developing at about 1.4% of those with the early introduction compared to 4.9% in those who had more of a delayed introduction.
So that early introduction is preventative, but what we're going to be talking about is oral immunotherapy as a therapeutic approach in those children who already have developed a peanut allergy.
So the tricky thing about this evidence is how you actually introduce oral immunotherapy in these kids can differ.
And they were looking at oral immunotherapy compared to placebo or avoidance.
So again, remembering that these are kids with already, they already have an established allergy.
So then you're introducing some sort of this immunotherapy versus, you know, going on and doing what you would do in most situations with an allergy, you'd be avoiding that allergy.
So it's essentially taking like peanut protein and starting kids on like a small amount of this protein and increasing it over time.
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