ArticleClinical and translational allergy2025
Safety and Efficacy of Very Low-Dose Multi-Nut Oral Immunotherapy in Children.
Article in Clinical and translational allergy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 2 papers.
What it found
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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.
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.
Low Dose Multi Allergen Oral Immunotherapy for Food Allergy
An Open-Label, Multicenter, Randomized Clinical Trial Evaluating the Efficacy and Safety of Oral Multi-Food Immunotherapy With Peanut and Tree Nuts Protein Mixtures
Who cites it
2 citing papers in PubMed.
- Taste aversion and adverse events contribute equally to OIT discontinuation in children: A real-world multi-allergen analysis.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Observational
- Safety and Efficacy of Very Low-Dose Multi-Nut Oral Immunotherapy in Children.Clinical and translational allergy · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
Abstract
backgroundOral immunotherapy (OIT) is a management strategy for food allergies, typically one at a time, with maintenance doses ≥ 300 mg protein. However, 30% of allergic children have multiple trigger foods, and large maintenance doses are associated with side effects. If efficacious, Very Low-Dose OIT (VLOIT) may enhance safety in multi-OIT.
methodsEighteen children with allergies to 2-5 nuts (tree nuts, peanuts) were enrolled (NCT03799328). Oral food challenge (OFC)-confirmed allergies to their nut mix at ≤ 444 mg protein each nut followed by initiation of an open-label mix of 4 mg protein/nut with dose increases every 2 months up to a maintenance dose of 30 mg protein/nut. After 18 months, an exit-OFC assessed allergic threshold changes, with a maximum of 2040 mg protein/nut. Efficacy was evaluated using pre-post treatment and proportional analyses (Wilcoxon signed-ranks, two-tailed Fisher's test).
resultsThe median age at enrollment was 5.0 years (IQR 3.13-9.62). The baseline median tolerated dose was 10 mg protein/nut (IQR 3-100 mg). Three withdrew, one did not reach the target maintenance but was invited for the exit OFC, resulting in 15/18 eligible for exit OFC. The median tolerated dose at exit OFC was 1000 mg (IQR 300-1000 mg), with a significant difference from baseline (p < 0.0001). Ten out of 15 participants tolerated the maximum dose (p < 0.0001). Intention-to-treat analysis showed that 14/18 children met pre-defined efficacy measures: tolerated 5X their baseline dose or ≥ 300 mg (p < 0.001). No patients required epinephrine during treatment.
conclusionsVLOIT led to a significant increase in the tolerated dose to multiple nuts.
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Registered trials
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.