Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut Allergy

Peanut allergy is a persistent and potentially life-threatening condition affecting millions worldwide, necessitating effective therapeutic strategies beyond strict avoidance. Oral immunotherapy (OIT) has emerged as a promising approach, with peanut (<i>Arachis hypogaea</i>) allergen pow...

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Main Authors: Edoardo Cavaglià, Guido Maria Valentini, Nicolò Valli, Giovanni Paoletti, Mattia Giovannini, Pasquale Comberiati, Alessandro Fiocchi, Alfredo Scardini, Maria Rita Messina, Giorgio Walter Canonica, Enrico Heffler, Antonio Bognanni
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Language:English
Published: MDPI AG 2025-04-01
Series:Applied Sciences
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Online Access:https://www.mdpi.com/2076-3417/15/9/4833
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author Edoardo Cavaglià
Guido Maria Valentini
Nicolò Valli
Giovanni Paoletti
Mattia Giovannini
Pasquale Comberiati
Alessandro Fiocchi
Alfredo Scardini
Maria Rita Messina
Giorgio Walter Canonica
Enrico Heffler
Antonio Bognanni
author_facet Edoardo Cavaglià
Guido Maria Valentini
Nicolò Valli
Giovanni Paoletti
Mattia Giovannini
Pasquale Comberiati
Alessandro Fiocchi
Alfredo Scardini
Maria Rita Messina
Giorgio Walter Canonica
Enrico Heffler
Antonio Bognanni
author_sort Edoardo Cavaglià
collection DOAJ
description Peanut allergy is a persistent and potentially life-threatening condition affecting millions worldwide, necessitating effective therapeutic strategies beyond strict avoidance. Oral immunotherapy (OIT) has emerged as a promising approach, with peanut (<i>Arachis hypogaea</i>) allergen powder dnfp (Palforzia Aimmune therapeutics Brisbane Calif]) being the first FDA-approved standardized OIT for peanut allergy. This review synthesizes current clinical evidence on PTAH (peanut-tolerant <i>Arachis hypogea</i>), focusing on its efficacy, safety, and long-term outcomes. A systematic literature search was conducted, analyzing key phase 3 trials, including PALISADE, ARTEMIS, and POSEIDON, as well as long-term extension studies such as ARC004 and ARC008. Findings indicate that PTAH significantly increases the peanut protein threshold tolerated by allergic individuals, reducing the risk of severe reactions upon accidental exposure. While adverse events such as gastrointestinal symptoms and anaphylaxis occur, they are generally manageable and decline over time with continued therapy. Notably, younger children in the POSEIDON trial exhibited higher desensitization rates, suggesting the potential benefits of early intervention. Long-term studies demonstrate sustained immune modulation, with reductions in peanut-specific IgE and an increase in IgG4, indicative of developing tolerance. Despite limitations such as adherence challenges and the need for ongoing maintenance dosing, PTAH represents a paradigm shift in peanut allergy management, offering improved safety and quality of life for patients and caregivers.
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spelling doaj-art-c152effb62bb408e8f1e0ce23434448b2025-08-20T02:59:11ZengMDPI AGApplied Sciences2076-34172025-04-01159483310.3390/app15094833Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut AllergyEdoardo Cavaglià0Guido Maria Valentini1Nicolò Valli2Giovanni Paoletti3Mattia Giovannini4Pasquale Comberiati5Alessandro Fiocchi6Alfredo Scardini7Maria Rita Messina8Giorgio Walter Canonica9Enrico Heffler10Antonio Bognanni11Personalized Medicine, Asthma & Allergy, Humanitas Clinical and Research Center, IRCCS, 20072 Rozzano, Milano, ItalyPersonalized Medicine, Asthma & Allergy, Humanitas Clinical and Research Center, IRCCS, 20072 Rozzano, Milano, ItalyPersonalized Medicine, Asthma & Allergy, Humanitas Clinical and Research Center, IRCCS, 20072 Rozzano, Milano, ItalyPersonalized Medicine, Asthma & Allergy, Humanitas Clinical and Research Center, IRCCS, 20072 Rozzano, Milano, ItalyAllergy Unit, Meyer Children’s Hospital IRCCS, 50139 Florence, ItalyDepartment of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, ItalyAllergy Unit, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, ItalyPersonalized Medicine, Asthma & Allergy, Humanitas Clinical and Research Center, IRCCS, 20072 Rozzano, Milano, ItalyPersonalized Medicine, Asthma & Allergy, Humanitas Clinical and Research Center, IRCCS, 20072 Rozzano, Milano, ItalyPersonalized Medicine, Asthma & Allergy, Humanitas Clinical and Research Center, IRCCS, 20072 Rozzano, Milano, ItalyPersonalized Medicine, Asthma & Allergy, Humanitas Clinical and Research Center, IRCCS, 20072 Rozzano, Milano, ItalyPersonalized Medicine, Asthma & Allergy, Humanitas Clinical and Research Center, IRCCS, 20072 Rozzano, Milano, ItalyPeanut allergy is a persistent and potentially life-threatening condition affecting millions worldwide, necessitating effective therapeutic strategies beyond strict avoidance. Oral immunotherapy (OIT) has emerged as a promising approach, with peanut (<i>Arachis hypogaea</i>) allergen powder dnfp (Palforzia Aimmune therapeutics Brisbane Calif]) being the first FDA-approved standardized OIT for peanut allergy. This review synthesizes current clinical evidence on PTAH (peanut-tolerant <i>Arachis hypogea</i>), focusing on its efficacy, safety, and long-term outcomes. A systematic literature search was conducted, analyzing key phase 3 trials, including PALISADE, ARTEMIS, and POSEIDON, as well as long-term extension studies such as ARC004 and ARC008. Findings indicate that PTAH significantly increases the peanut protein threshold tolerated by allergic individuals, reducing the risk of severe reactions upon accidental exposure. While adverse events such as gastrointestinal symptoms and anaphylaxis occur, they are generally manageable and decline over time with continued therapy. Notably, younger children in the POSEIDON trial exhibited higher desensitization rates, suggesting the potential benefits of early intervention. Long-term studies demonstrate sustained immune modulation, with reductions in peanut-specific IgE and an increase in IgG4, indicative of developing tolerance. Despite limitations such as adherence challenges and the need for ongoing maintenance dosing, PTAH represents a paradigm shift in peanut allergy management, offering improved safety and quality of life for patients and caregivers.https://www.mdpi.com/2076-3417/15/9/4833PTAHoral immunotherapypeanut allergypeanut (<i>Arachis hypogaea</i>) allergen powderclinical outcomesdesensitization
spellingShingle Edoardo Cavaglià
Guido Maria Valentini
Nicolò Valli
Giovanni Paoletti
Mattia Giovannini
Pasquale Comberiati
Alessandro Fiocchi
Alfredo Scardini
Maria Rita Messina
Giorgio Walter Canonica
Enrico Heffler
Antonio Bognanni
Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut Allergy
Applied Sciences
PTAH
oral immunotherapy
peanut allergy
peanut (<i>Arachis hypogaea</i>) allergen powder
clinical outcomes
desensitization
title Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut Allergy
title_full Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut Allergy
title_fullStr Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut Allergy
title_full_unstemmed Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut Allergy
title_short Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut Allergy
title_sort oral immunotherapy with standardized peanut extract a game changer for peanut allergy
topic PTAH
oral immunotherapy
peanut allergy
peanut (<i>Arachis hypogaea</i>) allergen powder
clinical outcomes
desensitization
url https://www.mdpi.com/2076-3417/15/9/4833
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