LEAPing through the looking glass: secondary analysis of the effect of skin test size and age of introduction on peanut tolerance after early peanut introduction

M. Greenhawt*, D. M. Fleischer, E. S. Chan, C. Venter, D. Stukus, R. Gupta, J. M. Spergel

*Corresponding author for this work

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Background: In the Learning Early About Peanut Allergy (LEAP) study, early peanut introduction in high-risk 4- to 11-month-olds was associated with a significantly decreased risk of developing peanut allergy. However, the influences of key baseline high-risk factors on peanut tolerance are poorly understood. Methods: Secondary analysis was conducted on the publically available LEAP dataset, exploring relationships between peanut tolerance, baseline peanut/egg sensitization, eczema severity/duration, age of introduction, gender, and race. Results: A multiple logistic regression model predicting odds of successful oral food challenge (OFC) at 60 months noted higher odds with early introduction (OR 9.2, P < 0.001, 95% CI 4.2–20.3), white race (OR 2.1, P = 0.04, 95% CI 1.1–3.9), and advancing age (OR 4.8, P = 0.04, 95% CI 1.1–20.8). Odds of peanut tolerance were lower with increasing peanut wheal size (OR 0.58, P < 0.001, 95% CI 0.46–0.74), increased baseline SCORAD score (OR 0.98, P = 0.04, 95% CI 0.97–1), and increased kUA/l of egg serum IgE (sIgE) (OR 0.99, P = 0.04, 95% CI 0.98–1). The probability of peanut tolerance in the early introduction group was 83% vs 43% in the avoidance group with SPT wheal of <4 mm. The probability of a successful OFC was significantly higher with peanut introduction between 6 and 11 months than at 4–6 months. Increasing eczema severity had limited impact on the probability of peanut tolerance in the early introduction arm. Conclusion: Increasing peanut wheal size predicted peanut tolerance only in the avoidance arm. Peanut introduction between 6 and 11 months of age was associated with the highest rates of peanut tolerance, questioning the ‘urgency’ of introduction before 6 months.

Original languageEnglish (US)
Pages (from-to)1254-1260
Number of pages7
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume72
Issue number8
DOIs
StatePublished - Aug 2017

Keywords

  • Learning Early about Peanut
  • allergy prevention
  • complementary feeding
  • early peanut introduction
  • peanut allergy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Fingerprint Dive into the research topics of 'LEAPing through the looking glass: secondary analysis of the effect of skin test size and age of introduction on peanut tolerance after early peanut introduction'. Together they form a unique fingerprint.

  • Cite this