Randomised trial · The New England journal of medicine · 2023Abstract only

Peanut patch for peanut allergy in toddlers

What it found

In children aged 1 to 3 with peanut allergy, wearing a peanut patch daily for 12 months helped more of them tolerate a larger amount of peanut protein than a placebo patch.

The trial was in people.

What they found

Studies in people

Response to treatment

At 12 months, 67.0% of children using the peanut patch met the response measure, compared with 33.5% using the placebo patch. The difference was 33.4 percentage points.

Side effects overall

Adverse events during patch use, whether or not related to treatment, occurred in 100% of the peanut patch group and 99.2% of the placebo group.

Serious side effects

Serious adverse events occurred in 8.6% of the peanut patch group and 2.5% of the placebo group. Anaphylaxis occurred in 7.8% and 3.4%, respectively.

Treatment-related reactions

Serious treatment-related adverse events occurred in 0.4% of the peanut patch group and none in the placebo group. Treatment-related anaphylaxis occurred in 1.6% of the peanut patch group and none in the placebo group.

What the authors conclude

“In this trial involving children 1 to 3 years of age with peanut allergy, epicutaneous immunotherapy for 12 months was superior to placebo in desensitizing children to peanuts and increasing the peanut dose that triggered allergic symptoms.”
Greenhawt M, Sindher SB, Wang J, et al, 2023

Also in their conclusions

  • They conclude that in children 1 to 3 years of age with peanut allergy, epicutaneous immunotherapy for 12 months was superior to placebo in desensitizing children to peanuts and increasing the peanut dose that triggered allergic symptoms.

How it was done

The authors note that no treatment for peanut allergy exists for children younger than 4 years of age, and it was unknown whether a peanut patch would work and be safe in toddlers.

They ran a phase 3, multicenter, double-blind, randomized, placebo-controlled trial in children 1 to 3 years of age with peanut allergy confirmed by a food challenge. Children who reacted to 300 mg or less of peanut protein were assigned 2:1 to a daily peanut patch or a placebo patch for 12 months. Of 362 children, 84.8% finished the trial.

What it can’t tell you

  • We summarised it from the abstract only.
  • The trial ran for 12 months, so it does not show what happens with longer use.
  • It does not show whether children stay desensitized after stopping the patch.

The paper

Title
Phase 3 Trial of Epicutaneous Immunotherapy in Toddlers with Peanut Allergy
Type
Randomised controlled trial
Evidence
Studies in people
Summarised from
Abstract only
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/NEJMoa2212895PubMed 37163622DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error