Therapy Helps Peanut-Allergic Children Tolerate Larger Amounts of Peanut Butter

A new study funded by the National Institutes of Health (NIH) suggests that children with peanut allergies who can already tolerate at least half a peanut may benefit from gradually increasing their peanut intake. Over 18 months, children who followed this treatment were able to consume three tablespoons of peanut butter without experiencing allergic reactions. The findings, published in NEJM Evidence, offer a potential treatment strategy for children with high-threshold peanut allergies who previously had limited options beyond avoidance.

This article is not medical advice. Consult your doctor before starting any new therapy or treatment program.

The study, known as the CAFETERIA trial, involved 73 children aged 4 to 14. Participants were randomly assigned either to gradually increase their peanut intake or to continue avoiding peanuts. Those in the treatment group started with 1/8 teaspoon of peanut butter daily and increased their dose every eight weeks under medical supervision. By the end of the study, all children in the peanut-ingestion group could tolerate nine grams of peanut protein—the equivalent of three tablespoons of peanut butter—compared to only a small fraction of children in the avoidance group.

Researchers also tested whether the treatment resulted in sustained tolerance. Children who completed the peanut therapy continued consuming at least two tablespoons of peanut butter weekly for 16 weeks, then avoided peanuts entirely for eight weeks. At the final oral food challenge, nearly 87% of treated children maintained their tolerance, compared to just 8.6% of those in the avoidance group who developed natural tolerance.

The study was conducted at the Elliot and Roslyn Jaffe Food Allergy Institute at Mount Sinai Kravis Children’s Hospital in New York. The research team, led by Dr. Scott Sicherer and Dr. Julie Wang, aims to explore whether this treatment approach could be effective for other food allergies. While further research is needed to confirm the long-term effects of the therapy, these results suggest a promising, accessible strategy for managing peanut allergies in children with higher tolerance thresholds.

Article by multiple RFHC contributors.

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