Peanut consumption starting in infancy and continuing to age 5 years provides lasting tolerance into adolescence, according to a study published in the June issue of NEJM Evidence.

George Du Toit, M.B., B.Ch., from King’s College London, and colleagues examined the durability of peanut tolerance at age 144 months after years of ad libitum peanut consumption. Five hundred eight of the original 640 participants were enrolled; 497 had complete primary end point data.

The researchers found that peanut allergy remained significantly more prevalent in participants in the original peanut avoidance group versus the original peanut consumption group at age 144 months (15.4 versus 4.4 percent). In both groups, participants reported avoiding peanuts for prolonged periods between 72 and 144 months. At 144 months, the levels of Ara h2-specific immunoglobulin E (a peanut allergen associated with anaphylaxis) and levels of peanut specific immunoglobulin G4 were 0.03 ± 3.42 kU/L and 535.5 ± 4.98 µg/L, respectively, in the peanut consumption group and 0.06 ± 11.21 kU/L and 209.3 ± 3.84 µg/L, respectively, in the peanut avoidance group. Adverse events occurred rarely, and most were related to the food challenge.

“Our trial provides clinical evidence that induction of tolerance by early introduction of peanut led to a sustained tolerance to oral intake of peanut,” the authors write. “The duration of protection, which persisted in the vast majority of participants in the LEAP [Learning Early About Peanut Allergy] trial, from at least age 6 to age 13 years, is consistent with the notion that true tolerance was achieved through this intervention.”

Several authors disclosed ties to the biopharmaceutical industry.

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