Two-year Post-Treatment Outcomes Following Peanut Oral Immunotherapy in the Probiotic and Peanut Oral Immunotherapy-003 Long-Term (PPOIT-003LT) Study
Bibliographic record
Abstract
The probiotic and peanut oral immunotherapy (PPOIT)-003 randomized control trial showed probiotics plus peanut (PP) oral immunotherapy (OIT) and peanut OIT to be effective at inducing remission and desensitization compared with placebo (remission: PPOIT 46%, OIT 51%, placebo 5%; desensitization: PPOIT 77%, OIT 73%, placebo 5%). This study examined the long-term benefits and limitations associated with each clinical outcome.Children aged 1 to 10 years with peanut allergy confirmed by double-blind placebo-controlled food challenge and originally randomized 2:2:1 as PPOIT:OIT:placebo were evaluated for 2 years after completing PPOIT-003.Peanut consumption, reactions, and health-related quality of life (HRQOL) were monitored prospectively at 1 and 2 years after trial completion and were examined by treatment group and clinical outcome (remission, desensitization without remission, and allergic).Of the 86% (151/176) of eligible children observed, peanut consumption 2 years after completion was similar for PPOIT (86.7%) and OIT (78.7%, P = .48) and lower for placebo (10.3%). More PPOIT and OIT children consumed peanut vs placebo at 1 and 2 years (risk difference [RD] range 0.68-0.76, all P < .001). In year 2, more PPOIT children consumed peanut vs OIT children (RD 0.08, P = .017). Allergic reactions decreased over time in all groups: (PPOIT 31.7% to 23.3%, OIT 37.7% to 19.7%, placebo 13.8% to 6.9%; remission 27.5% to 15.9%; desensitization 57.9% to 36.8%; allergic 11.6% to 7%). After 2 years, similar proportions of remission and allergic children reported reactions (RD 0.09 [95% CI −0.03, 0.20], P = .127); more desensitized children reported reactions: (remission vs desensitized: RD −0.21 [95% CI −0.39; −0.03], P = .02) and (desensitized vs allergic: RD 0.30 [95% CI 0.13, 0.47], P = .001), and epinephrine use: 0% in remission, 5.3% of desensitized, and 2.3% of allergic children. Children in remission had greater HRQOL improvement than desensitized (Mean difference [MD] −0.54 [95% CI −0.99, −0.10], P = .017) and allergic (MD −0.82 [95% CI −1.25, −0.38], P < .001) children.Two years after PPOIT-003 completion, children with peanut allergy in remission reported fewer allergic reactions and greater HRQOL improvement. Desensitization allowed similar peanut consumption with less improvement in allergic reactions and HRQOL.In this study, remission of peanut allergy optimized consumption of peanut, caused fewer allergic reactions, and improved quality of life. Desensitization, the most common outcome, had limitations regarding improvement of allergic reactions and quality of life. These findings offer detailed follow-up regarding OIT and demonstrate the ongoing importance of providing children and families with information to allow them to choose the mode of treatment that best meets their needs.
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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 | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".