Evidence map›Paper›PMID 31030987›Full record

SynthesisLancet (London, England)2019

Oral immunotherapy for peanut allergy (PACE): a systematic review and meta-analysis of efficacy and safety.

Derek K Chu, Robert A Wood, Shannon French, Alessandro Fiocchi, Manel Jordana, Susan Waserman, Jan L Brożek, Holger J Schünemann

Erratum issuedAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Lancet (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 164 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
164citing papers in PubMed, 12 pooled it
33.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

164 citing papers in PubMed, 12 syntheses or guidelines pooled it, 429 citations in OpenAlex.

  1. Pooled it
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  4. Guideline
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  9. Improvement in Health-Related Quality of Life in Food-Allergic Patients: A Meta-Analysis.The journal of allergy and clinical immunology. In practice · 2021
    Pooled it
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  13. Trial
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  15. Dosing Reactions and Missed Doses Affect Peanut Oral Immunotherapy Outcomes.The journal of allergy and clinical immunology. In practice · 2026
    Trial
  16. Pragmatic Low-Dose Oral Immunotherapy for Preschool Children With Peanut Allergy: A Randomised Controlled Trial.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2025
    Trial
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  18. Omalizumab for the Treatment of Multiple Food Allergies.The New England journal of medicine · 2024
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  20. Trial

104 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 3 countries.

Derek K ChuDepartment of Medicine, McMaster University, Hamilton, Ontario, ON, Canada; St Joseph's Healthcare Hamilton, Hamilton, Ontario, ON, Canada. Electronic address: chudk@mcmaster.ca.
Robert A WoodDivision of Allergy & Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Shannon FrenchDepartment of Medicine, McMaster University, Hamilton, Ontario, ON, Canada; Department of Pediatrics, McMaster University, Hamilton, Ontario, ON, Canada; St Joseph's Healthcare Hamilton, Hamilton, Ontario, ON, Canada.
Alessandro FiocchiAllergy Division, Bambino Gesù Children's Hospital, Istituti di Ricovero e Cura a Carattere Scientifico, Rome, Italy.
Manel JordanaDepartment of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, ON, Canada.
Susan WasermanDepartment of Medicine, McMaster University, Hamilton, Ontario, ON, Canada; St Joseph's Healthcare Hamilton, Hamilton, Ontario, ON, Canada.
Jan L BrożekDepartment of Medicine, McMaster University, Hamilton, Ontario, ON, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, ON, Canada; Michael G DeGroote Cochrane Canada Centre, Hamilton, ON, Canada.
Holger J SchünemannDepartment of Medicine, McMaster University, Hamilton, Ontario, ON, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, ON, Canada; St Joseph's Healthcare Hamilton, Hamilton, Ontario, ON, Canada; Michael G DeGroote Cochrane Canada Centre, Hamilton, ON, Canada.
Cochrane · CAMcMaster University · CASt. Joseph’s Healthcare Hamilton · CAIstituti di Ricovero e Cura a Carattere Scientifico · ITJohns Hopkins Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOral immunotherapy is an emerging experimental treatment for peanut allergy, but its benefits and harms are unclear. We systematically reviewed the efficacy and safety of oral immunotherapy versus allergen avoidance or placebo (no oral immunotherapy) for peanut allergy.

methodsIn the Peanut Allergen immunotherapy, Clarifying the Evidence (PACE) systematic review and meta-analysis, we searched MEDLINE, EMBASE, Cochrane Controlled Register of Trials, Latin American & Caribbean Health Sciences Literature, China National Knowledge Infrastructure, WHO's Clinical Trials Registry Platform, US Food and Drug Administration, and European Medicines Agency databases from inception to Dec 6, 2018, for randomised controlled trials comparing oral immunotherapy versus no oral immunotherapy for peanut allergy, without language restrictions. We screened studies, extracted data, and assessed risk of bias independently in duplicate. Main outcomes included anaphylaxis, allergic or adverse reactions, epinephrine use, and quality of life, meta-analysed by random effects. We assessed certainty (quality) of evidence by the GRADE approach. This study is registered with PROSPERO, number CRD42019117930.

results12 trials (n=1041; median age across trials 8·7 years [IQR 5·9-11·2]) showed that oral immunotherapy versus no oral immunotherapy increased anaphylaxis risk (risk ratio [RR] 3·12 [95% CI 1·76-5·55], I

interpretationIn patients with peanut allergy, high-certainty evidence shows that available peanut oral immunotherapy regimens considerably increase allergic and anaphylactic reactions over avoidance or placebo, despite effectively inducing desensitisation. Safer peanut allergy treatment approaches and rigorous randomised controlled trials that evaluate patient-important outcomes are needed.

fundingNone.

Indexed as

Administration, OralChildChild, PreschoolDesensitization, ImmunologicFemaleHumansMalePeanut HypersensitivityQuality of LifeRandomized Controlled Trials as Topic

Identifiers

PMID31030987
OpenAlexW2942283768

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.