Current Insights

A Systemic Review of Therapeutic Options for Peanut Allergy

Eimear O'Rourke; Hilary Tang; Andrew Chin; Andrew Long; Sayantani Sindher; R. Sharon Chinthrajah


Curr Opin Allergy Clin Immunol. 2022;22(3):188-193. 

In This Article

Conclusion and Future Directions

To date, oral and epicutaneous immunotherapies with peanut have consistently demonstrated promise in the safe and effective treatment of PAs, along with a positive impact on the QoLin those affected. Current trials are underway to evaluate novel treatment strategies that build upon the existing fundamentals of EPIT and OIT in an effort to reduce the rate and severity of treatment-associated AEs as well as expedite the desensitization process and improve rates of SU. The majority of such focus on the use of selective biologic agents to temporarily suppress specific immunologic mediators of the allergic response. Current trials include those investigating the use of omalizumab, an anti-IgE antibody, with or without concomitant multi-OIT that includes peanut (OUtMATCH, NCT03881696); dupilumab, -an anti-IL4Ra antibody, with or without peanut OIT (NCT03793608, NCT03682770); or both biologics in combination with concomitant multi-OIT that includes peanut (COMBINE, NCT03679676). Beyond biologic adjuncts, additional strategies that instead depend on providing peanut exposure in ways that avoid triggering reactive pathways are under evaluation. These agents include an intradermal DNA vaccine, ARA-LAMP-vax, that codes for major peanut allergens (NCT02851277, NCT03755713), in addition to nanoparticle encapsulated peanut extract, CNP-201, delivered intravenously (NCT04950504).