Time to reach maintenance and rate of desensitization
In the study population, 21 (87%) of CN-allergic patients and 27 (71%) of peanut-allergic patients reached the maintenance phase or successfully completed therapy with desensitization. Among these patients, those in the CN group reached maintenance faster, with a median time of 8 months (range 0 to 16 months), compared to 10 months (range 0 to 18 months) in the peanut group (Fig. 4A). Children with asthma (Fig. 4B) or another food allergy (Fig. 4C) needed longer to reach maintenance. There was no significant difference in reaching the maintenance phase for patients with allergic rhinitis or atopic dermatitis compared to those without.
Due to the limited observation duration since OIT initiation, few patients completed the maintenance phase and underwent a second oral food challenge. Additionally, three patients (two from the peanut group and one from the CN group) chose not to proceed with a second challenge due to various reasons (relocation, illness, personal preference). Among the CN group, nine patients underwent a second OFC, with eight (88%) showing tolerance to 4.4 g nut protein, indicating desensitization. One patient experienced a mild reaction (oral pruritus) at 3 g protein, compared to the initial OFC’s 0.1 g reactive dose (generalized urticaria). In the peanut group, 13 patients had a second OFC, with 9 of them (69%) having no allergic reaction to 4.4 g nut protein. Among the four patients who exhibited intolerance during the second challenge, three experienced moderate reactions to the last step of the protocol (3 g nut protein), having previously experienced grade 4 allergic reactions. One patient had both a moderate reaction in the initial exposure to peanut and in the final OFC.