Allergy London’s Professor Stephen Till, was a co-author of the first clinical trial investigating whether oral immunotherapy may significantly reduce peanut sensitivity in adults with allergies. The study showed promising results, with two-thirds of participants able to consume the equivalent of five peanuts without experiencing an allergic reaction.
This landmark study, called the Grown Up Peanut Immunotherapy (GUPI) trial, is the first to focus exclusively on adults with severe peanut allergies. It tested whether daily, carefully supervised doses of peanut protein could be safely introduced and tolerated.
While OIT has already proven effective in infants and children around the world, this is the first time the method has been studied solely in an adult group. The findings were published today in the journal Allergy by researchers from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust. The study was funded by the National Institute for Health and Care Research (NIHR) through its Research for Patient Benefit Programme.
- Trial overview: A Phase II study at Guy’s and St Thomas’ NHS Foundation Trust enrolled 21 adults (ages 18–40) with confirmed peanut allergies, verified through skin prick tests, blood tests, and oral food challenges.
- Initial dosing: Participants began with escalating doses of peanut flour (0.8 mg, 1.5mg, and 3 mg) under clinical supervision. Those who tolerated at least 1.5mg continued daily dosing at home for two weeks (equivalent to 0.5–1% of a peanut).
- Dose escalation: Over several weeks, supervised doses gradually increased from 6mg (around 1/40th of a peanut) to 1g (four peanuts) of peanut protein. If participants tolerated 50–100 mg, they transitioned to whole peanut products with the first dose being under supervision of the clinical team.
- Food challenge and maintenance: After maintaining a 1g daily dose for four weeks, participants underwent a double-blind, placebo-controlled food challenge. They then continued daily dosing for at least three more months.
- Results: 67% of participants could consume at least 1.4g of peanut protein (about five peanuts) without reacting. The trial suggests adults can be successfully desensitised through oral immunotherapy, with larger trials planned to confirm findings and identify ideal candidates.
Professor Stephen Till said: “We are very pleased with the results. The efficacy rate is broadly in line with peanut oral immunotherapy trials in children. The next stage of the research will be confirming this in larger trials, and also identifying the group of adult patients who would most likely benefit from oral immunotherapy, and see whether it can lead to long-term tolerance in this age group.”
Read the full study published in the Journal of Allergy and Clinical Immunology
