2078- Immunotherapy – 2078. Allergen-specific oral immunotherapy for peanut allergy: a Cochrane systematic review
Bibliographic record
Abstract
This article was originally published online on 23 April 2013 Allergen-specific oral immunotherapy (OIT) aims to induce desensitisation and immune tolerance, which should if successful reduce the risk of further reactions to peanuts and peanut-containing foods. We performed a systematic review of intervention studies by searching 13 databases and contacting an international panel of experts. Studies were critically appraised using Cochrane criteria. We identified one RCT with 28 children age 1-16 years (19 in the OIT group and nine in the placebo group). Because of allergic side-effects, three children were withdrawn from the OIT group early in the study. The remaining 16 participants in the OIT group completed the study and ingested a maximum cumulative dose (MCD) of 5000 mg (≈20 peanuts). All 9 participants in the placebo group completed the study, but ingested an MCD of only 280 mg (range, 0-1900 mg, P<0.001). Children in the OIT group had reductions in peanut-specific skin prick tests (P<0.001), IL-5 (P=0.01), and IL-13 (P=0.02), and increases in peanut-specific IgG4 (P<0.01) and T reg cells. Nine children (47%) of the 19 in the OIT group experienced side-effects and two of them required epinephrine treatment. We found one small RCT judged to be at low risk of bias which showed that peanut OIT can result in desensitisation in children, and that this is associated with evidence of concurrent immune-modulation. This treatment approach was however associated with substantial risk of adverse reactions, although most of these were mild. Thus, peanut OIT cannot currently be recommended as a treatment for the management of patients with IgE-mediated peanut allergy. Larger RCTs are needed investigating the acceptability, effectiveness and cost-effectiveness of safer treatment regimens, particularly in relation to the induction of long-term immune tolerance.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.027 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.008 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.019 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".