Transitioning individuals with peanut allergy from US Food and Drug Administration-approved peanut oral immunotherapy to a dietary peanut product

Abstract

Management of peanut allergy (PA) has expanded from strict avoidance with prompt treatment of accidental exposures to include the option of peanut oral immunotherapy (POIT).1,2 Although off-label POIT has been used for years, in 2020, the US Food and Drug Administration (FDA) approved Arachis hypogaea allergen powder (Palforzia, Aimmune, Brisbane, California) for POIT in the management of PA.3 An increasing number of allergists are offering POIT in clinical practice,4 but barriers remain. Despite similar risks to off-label POIT, uptake of FDA-approved POIT remains low, with the 2 most typically cited reasons to forego this option being concerns over adverse effects and the commitment required to be adherent with therapy.