Peanut patch treatment for peanut allergy in toddlers
What it found
A daily peanut skin patch helped allergic toddlers aged 1 to 3 tolerate more peanut protein after 12 months.
The patch group had more serious allergic reactions than the dummy patch group.
What they found
Studies in people
Tolerating more peanut
After 12 months, 67% of children using the peanut patch could handle a larger dose of peanut protein without reacting. Only 33.5% of children using the dummy patch improved by that measure.
Skin reactions at patch site
Nearly all children in both groups had some skin reaction where the patch was placed. Redness happened in 98.0% of the peanut patch group and 90.7% of the dummy patch group. Itching occurred in 94.7% and 61.0%, respectively.
Serious allergic reactions
Serious side effects happened in 8.6% of the peanut patch group and 2.5% of the dummy patch group. Severe allergic reactions called anaphylaxis occurred in 7.8% of the peanut patch group and 3.4% of the dummy patch group. Investigators linked four anaphylaxis cases to the peanut patch and none to the dummy patch.
Accidental peanut exposure
Some children accidentally ate peanut during the year. Among those who did, fewer children in the peanut patch group had an allergic reaction compared to the dummy patch group (5.3% versus 10.2%).
What the authors conclude
- They conclude that 12 months of daily treatment with the peanut patch helped toddlers tolerate more peanut protein than a dummy patch.
- They say this level of improvement is enough to lower the chance of an allergic reaction from accidental exposure.
- The authors note the patch delivers about one thousandth of a single peanut.
How it was done
Peanut allergy affects about 2% of children in western countries and is rising. No treatment was available for children under 4 years old, so the authors tested a skin patch delivering a tiny amount of peanut protein.
The trial enrolled 362 children aged 1 to 3 with confirmed peanut allergy across 51 sites in 8 countries. Children wore either a peanut patch or a dummy patch every day for 12 months. Researchers then tested how much peanut protein each child could handle before reacting.
What it can’t tell you
- This trial lasted 12 months, so it cannot show whether the benefits last after children stop wearing the patch.
- Children with a history of very severe peanut reactions were excluded, so the results may not apply to them.
- Most participants were white and male, which may limit how well the findings apply to other groups.
Who paid
- Authors work at
- University of Colorado School of Medicine, D.M.F.; Icahn School of Medicine at Mount Sinai, H.A.S.; University of Queensland, NSW (B.W.) - all in Australia
The paper
- Title
- Phase 3 Trial of Epicutaneous Immunotherapy in Toddlers with Peanut Allergy
- Type
- Randomised controlled trial
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Greenhawt M, Sindher SB, Wang J, et al (2023). Phase 3 Trial of Epicutaneous Immunotherapy in Toddlers with Peanut Allergy. The New England journal of medicine. doi:10.1056/NEJMoa2212895Free full textPubMed 37163622DOI
Summary written 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error